The PREVENT Risk Equations and Cardiovascular Prevention in East Asia

Area of Science:

• Cardiology
• Epidemiology
• Preventive Medicine

Background:

• Cardiovascular disease (CVD) is a major health concern in East Asia, with unique epidemiological trends.
• Aging populations in East Asia are increasing chronic kidney disease, diabetes, and heart failure, heightening the need for accurate CVD risk prediction.
• Existing Western-derived risk models often overestimate CVD risk in East Asian populations.

Purpose of the Study:

• To review the evolution of cardiovascular risk prediction models.
• To highlight the innovations of the PREVENT equations within an integrated cardiovascular-kidney-metabolic framework.
• To assess the performance and transportability of the PREVENT equations in East Asian populations.

Main Methods:

• Review of existing literature on cardiovascular risk prediction models.
• Analysis of the PREVENT equations' framework and components.
• Examination of emerging validation studies of PREVENT in East Asian cohorts (Korea, China, Japan).

Main Results:

• Traditional models like Framingham, Pooled Cohort Equations, and SCORE require recalibration for East Asian populations.
• Early validation studies from Korea and China suggest the PREVENT equations are reasonably transportable.
• Evidence from Japan is limited, indicating a need for further validation and potential recalibration.

Conclusions:

• The PREVENT equations represent a significant advancement in cardiovascular risk prediction, integrating kidney and metabolic factors.
• While initial findings in East Asia are encouraging, further research is essential for widespread clinical implementation.
• Challenges remain in heart failure prediction, incorporating additional variables, leveraging electronic health records, and exploring AI-assisted risk assessment.