Use of the Predicting Risk of Cardiovascular Disease (CVD) Events (PREVENT) equations predicts risk of CVD in diverse Asian and Hispanic subgroups, enhancing equity in CVD risk prediction, a new retrospective study finds. Xiaowei Yan, PhD, MS, MPH, from the Center for Health Systems Research, Walnut Creek, California, and colleagues, discussed the corresponding data in a manuscript published online June 25 in the Journal of the American Medical Association. “Results demonstrated good performance in those racial/ethnic groups, and within Asian and Hispanic subgroups too,” Dr. Yan told CRTonline. “It further backs up PREVENT equations for their generalizability and robustness.” Performance of the PREVENT equations has not been thoroughly examined in Asian and Hispanic populations, though the equations have shown good discrimination and calibration among other racial and ethnic groups. “The performance of the PREVENT equations across disaggregated Asian and Hispanic populations reinforces their clinical utility in risk stratification, offering clinicians a validated tool to guide preventive cardiovascular care in historically understudied groups,” said Brian C. Case, MD, of MedStar Southern Maryland Hospital Center, Clinton, in an interview with CRTonline. This electronic health record-based cohort study examined the performance of the PREVENT equations in primary care patients (30-79 years old) across Sutter Health between January 2010 and September 2023. CVD events, defined by the International Classification of Diseases, Ninth and Tenth Revisions, were the primary outcomes in this study. A total of 361,778 patients (mean age=54.6 years, 53% female) were eligible after accounting for exclusion criteria. All patients had complete baseline data for the PREVENT equations: non–high-density lipoprotein cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, body mass index, estimated glomerular filtration rate (or creatinine), diabetes and current smoking status, and were free from cardiovascular disease (CVD) at baseline. In the patient population investigated, 22% were non-Hispanic Asian and 11% were Hispanic. A total of 22,648 CVD events occurred over the mean follow-up of 3.2 years. In the Asian population, the C statistic total for CVD was 0.83 (95% confidence interval [CI]=0.82-0.84) and 0.80 for the Hispanic population (95% CI=0.79-0.81). Calibration slopes were 0.84 and 1.02 for the Asian and Hispanic populations. All Asian subgroups had a total CVD calibration slope less than 1 except Asian Indians. All subgroups of Hispanics had similar C statistics and a calibration slope of 1. “It is a stepstone to create future clinical guidelines based on PREVENT equations on CVD prevention,” said Dr. Yan. “[The study] provides concrete evidence on the superior performance of PREVENT equation compared to the pooled cohort equation (PCE), currently used in clinical guideline for treatment recommendation.” In an invited commentary, Nilay S. Shah, MD, MPH, of the Northwestern University Feinberg School of Medicine, Chicago, highlighted the importance of equitable clinical CVD prevention. Dr. Shah explained that, while the PREVENT models should be further investigated for future use, the paper by Dr. Yan and colleagues is a step in the right direction for Asian and Hispanic communities who have historically been left unseen in CVD prevention guidelines. Christopher M. Kramer, MD, President of the American College of Cardiology (ACC), and Melvin R. Echols, MD, MSCR, ACC Chief Health Equity Advancement and Inclusion Officer, published a statement online discussing health equity in the Journal of the American College of Cardiology on June 19. “Ultimately, excellence in cardiovascular care cannot be realized without equity,” Drs. Kramer and Echols concluded. The results of the study by Yan et al. echo the need for enhancement in health equity. Sources: Yan X, Bacong AM, Huang Q, et al. Performance of the American Heart Association’s PREVENT equations among disaggregated racial and ethnic subgroups. JAMA. 2025 June 25 (Article in press). Shah NS. Advancing equity in cardiovascular disease risk prediction. JAMA. 2025 June 25. (Article in press). Kramer CM, Echols MR. Health equity in cardiovascular care: A clinical imperative for better outcomes. J Am Coll Cardiol. 2025 June 19. Image Credit: VectorMine – stock.adobe.com