What Does PREVENT-Age Tell Us About Cardiovascular Risk?

PREVENT risk age was derived from the 10-year total cardiovascular disease risk calculated using the PREVENT base model.

On average, PREVENT risk age was higher than chronological age in both women and men.

Among women, mean PREVENT risk age was 55.4 years, compared with a mean chronological age of 51.3 years — an average difference of 4.1 years.

Among men, mean PREVENT risk age was 56.7 years, compared with a mean chronological age of 49.7 years — an average difference of approximately 6.9 years.

The differences were substantial for many individuals. PREVENT risk age exceeded chronological age by more than 5 years in 36.3% of women and 56.4% of men. It was more than 10 years higher in 16.1% of women and 26.0% of men.

Differences also varied across sociodemographic groups. Among adults with a high school education or less, 22.8% of women and 32.5% of men had a PREVENT risk age more than 10 years above their chronological age.

The authors highlighted another potentially important application: PREVENT risk age can make an unfavorable cardiovascular risk profile more apparent in younger adults whose absolute 10-year risk remains relatively low because of their age.

Chronological age is a powerful determinant of absolute cardiovascular risk. This creates an important challenge in prevention: a younger person can have several unfavorable cardiovascular risk factors while still receiving a relatively low 10-year absolute risk percentage.

PREVENT-Age offers another way to communicate that information.

Instead of presenting only a percentage, it translates predicted cardiovascular risk into an age-equivalent comparison. A substantial difference between PREVENT-Age and chronological age may make an unfavorable risk profile easier to recognize and understand.

For longevity medicine, this is particularly relevant because cardiovascular prevention is not limited to predicting events in the next few years. Identifying an unfavorable risk profile earlier may create more time to address modifiable factors before cardiovascular disease becomes clinically apparent.

PREVENT-Age should be interpreted alongside absolute cardiovascular risk, not as a replacement for it.

The two measures answer related but different questions. Absolute risk estimates the probability of developing cardiovascular disease over a defined period. PREVENT-Age expresses that predicted risk as the age of a person with an optimal reference profile who would have an equivalent risk.

The definition of that reference profile is clinically interesting. A systolic blood pressure of 110 mmHg, non-HDL cholesterol of 120 mg/dL and eGFR of 90 mL/min/1.73 m², together with absence of smoking and diabetes, provide the benchmark against which cardiovascular risk age is calculated.

This does not mean that these values should automatically become treatment targets for every patient. Treatment goals depend on the individual’s clinical circumstances, overall cardiovascular risk, comorbidities and current guidelines. Their importance here is methodological: they show what PREVENT-Age uses as its reference for an optimal risk-factor profile.

It is also essential to distinguish PREVENT-Age from biological age. PREVENT-Age is a cardiovascular risk age. It does not measure the biological age of the heart, arteries or body as a whole.

Finally, this was a cross-sectional population study. It developed the risk-age equations and examined their distribution in US adults, but it did not demonstrate that communicating PREVENT-Age improves lifestyle behavior, adherence to preventive treatment or cardiovascular outcomes. Those questions require prospective research.