PREVENT is the American Heart Association's risk calculator that estimates your chance of a heart attack or stroke over the next 10 years (and, from age 30 to 59, over 30 years), and it's the score the 2026 US cholesterol guideline uses to guide treatment.
Also called: PREVENT, PREVENT equations, PREVENT-ASCVD, AHA PREVENT calculator.
General information, not medical advice
Ranges and goals vary with your overall heart risk and between labs. Go through your own results with your doctor or another qualified health professional.
What it measures
PREVENT (Predicting Risk of cardiovascular disease EVENTs) was published by the American Heart Association in 2023, developed and tested on data from more than 6.5 million US adults. It gives separate estimates for total cardiovascular disease, for heart attack and stroke (PREVENT-ASCVD, the version the cholesterol guideline uses) and for heart failure. It's for adults aged 30 to 79 who don't already have heart or artery disease.
Inputs: age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure treatment, statin use, diabetes, smoking and kidney function (eGFR). Urine albumin, HbA1c and US zip code are optional extras. LDL and race aren't inputs. The AHA revised the calculator on October 14, 2026 to fix an issue with the optional HbA1c input.
PREVENT replaced the older Pooled Cohort Equations, which tended to overestimate risk. PREVENT's 10-year estimates are generally 40–50% lower for the same person.
Risk categories (10-year PREVENT-ASCVD)
| 10-year risk | What the 2026 guideline says |
|---|---|
| Under 3%: low | Lifestyle first; a statin may be reasonable if LDL is 160–189 mg/dL or the 30-year risk is 10% or more |
| 3% to under 5%: borderline | A statin is reasonable after discussing it with your doctor |
| 5% to under 10%: intermediate | A statin is recommended |
| 10% or more: high | A statin, with an LDL goal under 70 mg/dL (1.8 mmol/L) |
If the decision is still unclear at borderline or intermediate risk, a coronary artery calcium (CAC) scan can help. In the UK, GPs use a different calculator, QRISK3, rather than PREVENT.
What raises and lowers your score
- Raises it: older age, higher blood pressure, smoking, diabetes, higher total cholesterol, lower HDL and reduced kidney function.
- Lowers it: bringing down blood pressure and cholesterol, stopping smoking and controlling blood sugar. Your age is the one input you can't change.
Deeper reading
Related terms
- ApoB
- HDL cholesterol
- LDL cholesterol
- Lipoprotein(a)
- Non-HDL cholesterol
- Triglycerides
- VLDL cholesterol
- All glossary terms
Frequently asked questions
What is the PREVENT calculator?
PREVENT is the American Heart Association's calculator for the 10-year and 30-year risk of heart disease, stroke and heart failure in adults aged 30 to 79 without existing heart disease. The 2026 ACC/AHA cholesterol guideline uses its PREVENT-ASCVD score to guide statin decisions.
What is a high PREVENT score?
A 10-year PREVENT-ASCVD risk of 10% or more is high. 5% to under 10% is intermediate, 3% to under 5% borderline, and under 3% low. Under the 2026 guideline a statin is recommended from 5% and reasonable from 3% after a discussion with your doctor.
Is PREVENT used in the UK?
No. NHS doctors use QRISK3, which NICE recommends for estimating 10-year heart and stroke risk. PREVENT was developed from US data and is used with US guidelines.
Sources
- Blumenthal RS, Morris PB, et al. 2026 ACC/AHA Guideline on the Management of Dyslipidemia. J Am Coll Cardiol. 2026;87(19). Also in Circulation, doi:10.1161/CIR.0000000000001423.
- Khan SS, et al. Development and validation of the American Heart Association's PREVENT equations. Circulation. 2024;149:430–449.
- American Heart Association: PREVENT online calculator
- NICE NG238: Cardiovascular disease risk assessment and reduction, including lipid modification
Track your numbers over time
Heart Tracker logs every cholesterol test in mg/dL or mmol/L and charts your total cholesterol, LDL, HDL and triglycerides over time, next to what you were eating. Free on iPhone, no account needed.
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