New statin risk model keeps eligibility stable

Researchers compare PREVENT with older models to see how new risk thresholds affect who qualifies for statins.

New statin risk model keeps eligibility stable

A new risk calculator called PREVENT, introduced in November 2023, uses more contemporary and diverse data to estimate the 10‑year risk of a heart attack or stroke. When this model is applied to the old 7.5% threshold from the Pooled Cohort Equations, far fewer adults would qualify. But the new analysis shows that lowering the threshold to 3%, 4%, or 5% would yield different outcomes. Notably, using a 3% threshold would keep the number of people eligible for statins roughly the same as today. The PREVENT equations also account for conditions like chronic kidney disease, diabetes, and obesity to refine risk estimates.

Statins offer clear benefits in reducing cardiovascular events when paired with lifestyle changes, and they cost little. Yet side effects exist, including muscle pain and a higher risk of developing type 2 diabetes over about ten years. Some experts argue the benefits may extend to thresholds as low as 2.5% or lower, while clinicians caution that broader use must balance diabetes risk with patient values and preferences. The American Heart Association and the American College of Cardiology are expected to publish guidelines in the spring, with a focus on shared decision making between doctors and patients.

The debate over thresholds shows medicine moving toward patient centered care. The PREVENT model reflects more recent data and a broader view of risk, but turning numbers into prescriptions remains a human task. The choice of threshold shapes who is offered treatment and who receives careful counseling about tradeoffs.

Policy makers face a tough balance: reduce preventable heart events without pushing statin use so far that diabetes risk and treatment burden rise. The coming guidelines will test how they reconcile numerical risk with individual health profiles and personal values, a challenge that goes beyond statistics to everyday clinical conversations.

Highlights

Guidelines will shape treatment decisions in the months ahead.