A new study published in JAMA Network has evaluated the impact of the American Heart Association’s PREVENT equations on eligibility for statin and antihypertensive therapies among US adults.
The PREVENT equations, developed as an alternative to the pooled cohort equations (PCEs), incorporate kidney function measures, exclude race as an input and are better adjusted for current populations. However, they predict lower cardiovascular disease risk compared to the PCEs.
Researchers analyzed data from the National Health and Nutrition Examination Surveys, covering 7,765 adults aged 30 to 79 [1]. They found that using PREVENT equations would reduce the number of adults eligible for statin therapy by approximately 14.3 million and for antihypertensive therapy by about 2.62 million.
This reclassification could lead to 107,000 additional cases of heart attacks or strokes over the next decade.
The study highlights that these changes in eligibility would disproportionately affect specific demographics. Men would see a more significant reduction in statin eligibility compared to women and Black adults would be more affected than White adults.
The study also suggests that fewer people would be recommended for high-intensity statin therapy, with many being downgraded to moderate-intensity therapy.
The importance for public health are significant. While the PREVENT equations may provide a more accurate risk assessment for some individuals, reducing recommended preventive treatments could result in a higher incidence of cardiovascular events [2].
The researchers emphasize the need for careful consideration of these findings in clinical guidelines to ensure that preventive measures effectively target those at the highest risk.
Adopting the PREVENT equations could substantially change cardiovascular disease prevention strategies in the US. The reduction in treatment eligibility highlights the importance of balancing accurate risk assessment with the need to maintain effective prevention measures to mitigate the overall burden of cardiovascular diseases.
[1] JAMA Network. Projected Changes in Statin and Antihypertensive Therapy Eligibility With the AHA PREVENT Cardiovascular Risk Equations
[2] Circulation. Novel Prediction Equations for Absolute Risk Assessment of Total Cardiovascular Disease Incorporating Cardiovascular-Kidney-Metabolic Health: A Scientific Statement From the American Heart Association
