Cardiovascular disease risk estimates for primary prevention in the US prediabetes and diabetes population using the PREVENT equation
Authors' conclusion
The PREVENT equations estimate substantially lower ASCVD risk compared with PCEs in diabetes and prediabetes populations. These differences substantially impact statin eligibility under current guidelines. The PREVENT equations offer a more comprehensive framework that may better reflect contemporary risk profiles, potentially improving targeted preventive strategies in these high-risk populations.
Study context
- Population
- US adults aged 40–75 years without known cardiovascular disease (CVD), with diabetes, prediabetes or no diabetes/prediabetes (National Health and Nutrition Examination Survey (NHANES) 2013–2020), representing ≈104 million US adults
- Participants
- 8,693 adults
- Exposure
- PREVENT equations vs 2013 Pooled Cohort Equations
- Outcome
- Estimated 10-year ASCVD risk with PREVENT vs PCEs
- Follow-up
- 10-year
Methodological detailsnationally representative, NHANES 2013-2020
- Nationally representative
- NHANES 2013-2020
Main finding
As reported in the abstract
10-year ASCVD risk, diabetes
Observational data: associations, not effects.
Further findings
| Outcome | PREVENT | PCEs |
|---|---|---|
| 10-year ASCVD risk, prediabetes | 4.0% (CI 3.7–4.2) | 7.5% (CI 6.8–8.2) |
- 10-year atherosclerotic CVD (ASCVD) risk, prediabetes: 95% CI
10-year heart failure (HF) risk by glycaemic status
- Diabetes
- 9.9% (95% CI, 9.3-10.4)
- Prediabetes
- 3.7% (95% CI, 3.4-4.0)
- No diabetes/prediabetes
- 2.8% (95% CI, 2.7-3.0)
Statin eligibility (2024 KDIGO guidelines)
- Diabetes, Pooled Cohort Equations (PCEs) vs PREVENT
- 81.6% to 56.5%
- Prediabetes, PCEs vs PREVENT
- 32.5% to 11.8%
Statin treatment among eligible
- Less than half of statin-eligible individuals were receiving treatment
Original publication
Cardiovascular disease risk estimates for primary prevention in the US prediabetes and diabetes population using the PREVENT equation. Diabetes Obes Metab. Published 20 August 2025. doi:10.
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