Explainer
PREVENT vs ASCVD: two heart risk calculators compared
If your heart risk number changed between checkups, the calculator may have changed, not your heart. Here is how the two compare.
The short answer
The ASCVD risk calculator uses the Pooled Cohort Equations from 2013 (Goff 2013). PREVENT is the American Heart Association's newer set of equations, published in 2024 (Khan 2024). PREVENT is built from more recent data, drops race, adds kidney function and statin use, starts at age 30 and can also predict heart failure (Khan 2024). For the same person, it usually gives a lower 10-year estimate (Anderson 2024).
Side by side
| ASCVD (Pooled Cohort Equations) | PREVENT | |
|---|---|---|
| Published | 2013 (Goff 2013) | 2024 (Khan 2024) |
| Ages | 40 to 79 | 30 to 79 |
| Predicts | Heart attack, death from coronary heart disease, or stroke | Those, plus heart failure; each can also be shown alone |
| Time frame | 10 years | 10 years, and 30 years for ages 30 to 59 |
| Race | Separate equations for white and African American adults | Not used |
| Kidney function (eGFR) | Not used | Required |
| Statin use | Not used | Used |
| Shared inputs | Sex, age, total and HDL cholesterol, systolic blood pressure, blood pressure medicine, diabetes, smoking | |
Why PREVENT usually gives a lower number
A 2024 study applied both calculators to a national sample of US adults without heart disease. The average 10-year estimate for heart attack and stroke was 8.0% with the Pooled Cohort Equations and 4.3% with PREVENT (Anderson 2024). Part of the gap is that PREVENT was built from more recent data (Khan 2024). It also accounts for the chance of dying from other causes first (Khan 2024).
Be careful comparing your own numbers. PREVENT's main result, which our calculator shows, is total cardiovascular disease, including heart failure. That number is higher than PREVENT's heart attack and stroke number alone, so it is not a like-for-like match with an old ASCVD result.
What it means for statin advice
The 2018 cholesterol guideline uses the Pooled Cohort Equations. A 10-year ASCVD risk of 7.5% or more puts an adult aged 40 to 75 in the group where a clinician and patient discuss starting a statin (AHA/ACC 2018). The same 2024 study estimated that if PREVENT replaced the older equations with the same cutoffs, more than 17 million fewer US adults would meet that cutoff (Anderson 2024). The 2025 high blood pressure guideline already uses PREVENT (AHA/ACC 2025).
Which equations and which cutoffs to use is a decision for your clinician, who will also weigh things neither calculator includes, such as family history, lipoprotein(a) or a coronary calcium score.
Which one does this site use?
Our heart risk calculator uses the PREVENT base model for total cardiovascular disease. The PREVENT explainer covers how it was built and its limits. Neither calculator is for people who already have heart disease, a stroke or heart failure.
Sources
- Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Circulation. 2014;129(25 Suppl 2):S49-S73. doi.org/10.1161/01.cir.0000437741.48606.98
- Khan SS, Matsushita K, Sang Y, et al. Development and Validation of the American Heart Association's PREVENT Equations. Circulation. 2024;149(6):430-449. doi.org/10.1161/CIRCULATIONAHA.123.067626
- Anderson TS, Wilson LM, Sussman JB. Atherosclerotic Cardiovascular Disease Risk Estimates Using the Predicting Risk of Cardiovascular Disease Events Equations. JAMA Intern Med. 2024;184(8):963-970. doi.org/10.1001/jamainternmed.2024.1302
- Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation. 2019;139(25):e1082-e1143. doi.org/10.1161/CIR.0000000000000625
- Jones DW, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Circulation. 2025;152:e114-e218. doi.org/10.1161/CIR.0000000000001356
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-26. Spotted an error? See About.