CV Risk Decision Tool v30.3

Clinician use only • AHA PREVENT + race-free MESA CAC risk + 2026 dyslipidemia decision support
PREVENT is calculated in your browser. If an actual CAC score is entered, the MESA-required variables are sent to the official MESA race-free calculator service.

1. Paste chart data

2. PREVENT inputs

PREVENT requires a valid eGFR.
Values <130 are floored to 130 for PREVENT only. MESA uses the entered value.
Used for treatment guidance. Never altered.
Values reported as <X are parsed as X for threshold logic (e.g. <10 → 10).
Optional PREVENT predictor.
Optional PREVENT predictor.
Optional PREVENT predictor. ZIP to SDI is not guessed.

3. Clinical context and CAC

PREVENT and MESA are primary-prevention risk calculators.
Enter 0 when CAC is zero. Any numeric value, including 0, can trigger race-free MESA if the other required inputs are known.
Qualitative CAC can inform treatment guidance, but MESA is not calculated without an actual Agatston score.
MESA definition: heart attack in a parent, sibling, or child.

4. Lipid treatment context

PREVENT uses current statin use. Nonstatins alone do not count as statin use.
Clinician result

PREVENT risk profile

—
10-year predicted risk
Total CVD
—
ASCVD + heart failure composite
ASCVD
—
MI / coronary death / stroke
Heart failure
—
PREVENT-HF
PREVENT-Age
—
Base-equation metric
Equivalent heart/risk age derived from 10-year PREVENT-CVD.
30-year predicted risk
Total CVD
—
Available through age 59
ASCVD
—
Available through age 59
Heart failure
—
Available through age 59
Idealized risk-factor scenario

Best-case from the modifiable factors shown below

Same age and nonmodifiable context. This is a hypothetical PREVENT recalculation for teaching, not a causal treatment-effect estimate.
—10-y total CVD
—10-y ASCVD
—10-y heart failure
What if?
Only applicable factors are offered. Combine as many as you want.
CVD, ASCVD, and HF are modeled separately; ASCVD + HF can numerically exceed total CVD. 30-year estimates apply only through age 59. PREVENT-Age always uses the base 10-year PREVENT-CVD equation even when an enhanced optional-predictor model is selected.
What to focus on

Clinical priority

—
Priority ranking is heuristic decision support based on current treatment gaps and risk context. It is not an individualized causal treatment-effect estimate.
Color-coded clinical context

Lipids & risk markers

Treatment support

Decision summary

Patient output

Patient letter

Patient output uses PREVENT for overall cardiovascular risk. MESA stays clinician-facing because it predicts a different coronary endpoint.
Guidelines & supporting evidenceRead more: evidence behind this tool

These are the principal guidelines, derivation studies, and validation studies supporting the calculations and decision pathways used above. Links open the original publication or official project page.

Current guidelines

2026 ACC/AHA Multisociety Dyslipidemia Guideline

Published March 13, 2026. Introduces PREVENT-based treatment thresholds, LDL and non-HDL goals, risk enhancers, and selective CAC reclassification.

2025 AHA/ACC High Blood Pressure Guideline

Supports contemporary BP thresholds, treatment decisions, and integration of predicted cardiovascular risk.

Official AHA PREVENT Calculator

Clinical implementation of 10- and 30-year CVD, ASCVD, and heart-failure risk estimates, including PREVENT-Age.

PREVENT models

Development and Validation of the AHA PREVENT Equations

Khan et al., Circulation, 2024. Derivation and validation of the sex-specific, race-free PREVENT equations in more than 6 million adults.

External Validation of PREVENT

Scheuermann et al., JAMA Network Open, 2024. Evaluates discrimination and calibration in a nationally representative US cohort.

PREVENT Risk Age Equations

Krishnan et al., JAMA Cardiology, 2025. Describes the PREVENT-Age communication metric displayed in this tool.

Coronary calcium & MESA

CAC Added to the PREVENT-ASCVD Equations

Huang et al., JAMA, 2026. Finds that CAC provides its greatest reclassification value in borderline- and intermediate-risk patients.

Derivation and Validation of the MESA CAC Risk Score

McClelland et al., JACC, 2015. Establishes the 10-year CHD model using traditional risk factors with and without CAC.

Official Race-Free MESA Risk Score

MESA’s current race-free calculator and project description. The model excludes race/ethnicity and related interaction terms.

For clinician use only. Decision support, not a substitute for clinical judgment. PREVENT is used for primary prevention. Established ASCVD follows the secondary-prevention pathway. Pregnancy and lactation require medication-specific review.
PREVENT engine: pinned public implementation of the AHA PREVENT equations. Race-free MESA: official MESA score-norace service when CAC is entered.

Clinical tool developed by Gennady Gelman, MD