*! version 1.0.0 17Jun2024

Title

prevent -- Computes AHA 10-year and 30-year risk of cardiovascular disease (atherosclerotic and heart failure)

Syntax

Compute 10-year CVD risk using data in memory:

prevent10
[if] [in]
,
options

Compute 30-year CVD risk using data in memory:

prevent30
[if] [in]
,
options

Immediate form of prevent10

prevent10i
,
options

Immediate form of prevent30

prevent30i
,
options

prevent10/prevent30 options

Required
female(varname) gender, where female = 1 and male = 0

age(varname) age in years between 30 and 79

chol(varname) total cholesterol level between 130 and 320 mg/dL

hdl(varname) high density lipoprotein level between 20 and 100 mg/dL

sbp(varname) systolic blood pressure between 90 and 200 mmHg

bmi(varname) body mass index between 18.5 and 40

gfr(varname) estimated glomerular filtration rate between 15 and 150

antihtn(varname) anti-hypertensive medication, where treated = 1 and not treated = 0

statin(varname) lipid-lowering medication (statin), where treated = 1 and not treated = 0

smoker(varname) smoking status, where smoker = 1 and non-smoker = 0

diabetes(varname) diabetes status, where diabetic = 1 and non-diabetic = 0

Optional
include produces indicator for whether patient's input values meet AHA guidelines for computing risk

immediate options

Required
female(#) gender, where female = 1 and male = 0

age(#) age in years between 30 and 79

chol(#) total cholesterol level between 130 and 320 mg/dL

hdl(#) high density lipoprotein level between 20 and 100 mg/dL

sbp(#) systolic blood pressure between 90 and 200 mmHg

bmi(#) body mass index between 18.5 and 40

gfr(#) estimated glomerular filtration rate between 15 and 150

antihtn(#) anti-hypertensive medication, where treated = 1 and not treated = 0

statin(#) lipid-lowering medication (statin), where treated = 1 and not treated = 0

smoker(#) smoking status, where smoker = 1 and non-smoker = 0

diabetes(#) diabetes status, where diabetic = 1 and non-diabetic = 0

Optional
include indicates whether patient's input values meet AHA guidelines for computing risk

Description

prevent10 computes 10-year risk for coronary vascular disease (CVD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF). Similarly,
prevent30 computes the 30-year risk for coronary vascular disease (CVD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF). The
risk equations were developed by the American Heart Association Cardiovascular-Kidney-Metabolic Scientific Advisory Group and were derived
and validated in a large, diverse sample of over 6 million individuals (Khan et al 2024). prevent10 and prevent30 produce risk estimates
using the base model described in Khan et al (2024).

prevent10i and prevent30i are the immediate forms of prevent10 and prevent30, respectively; see immed.

Remarks

The risk for each outcome (CVD, ASCVD, HF) is calculated by separate models. Individuals may develop both ASCVD and HF. Therefore, the predicted risk of the
components (ASCVD, HF) may be greater than the predicted risk of the composite outcome (CVD) [Khan et al 2024].

Examples

Setup

. use "example_prevent.dta", clear

Run prevent10 to compute 10 year risk, using data in memory

. prevent10 , female(female) age(age) chol(chol) hdl(hdl) sbp(sbp) diab(diab) smoke(smoke) bmi(bmi) gfr(gfr) antihtn(antihtn) statin(statin)

Rerun prevent10, specifying the "include" option to indicate whether patients' input values meet AHA guidelines for computing CVD risk

. prevent10 , female(female) age(age) chol(chol) hdl(hdl) sbp(sbp) diab(diab) smoke(smoke) bmi(bmi) gfr(gfr) antihtn(antihtn) statin(statin) include

Run prevent30 to compute 30 year risk, using data in memory

. prevent30 , female(female) age(age) chol(chol) hdl(hdl) sbp(sbp) diab(diab) smoke(smoke) bmi(bmi) gfr(gfr) antihtn(antihtn) statin(statin) include

Run prevent10i to predict 10-year risk for an individual case

. prevent10i , female(1) age(50) chol(200) hdl(45) sbp(160) diab(1) smoke(0) bmi(35) gfr(90) antihtn(1) statin(0) include

Run prevent30i to predict 30-year risk for an individual case

. prevent30i , female(1) age(50) chol(200) hdl(45) sbp(160) diab(1) smoke(0) bmi(35) gfr(90) antihtn(1) statin(0) include

Stored results

prevent10i and prevent30i store the following in r():

Scalars

r(ascvd10) 10-year risk estimate for ASCVD

r(cvd10) 10-year risk estimate for CVD

r(hf10) 10-year risk estimate for HF

r(ascvd30) 30-year risk estimate for ASCVD

r(cvd30) 30-year risk estimate for CVD

r(hf30) 30-year risk estimate for HF

References

Khan, S. S., Matsushita, K., Sang, Y., et al. Development and validation of the American Heart Association
Predicting Risk of Cardiovascular Disease EVENTs (PREVENT^TM) equations. Circulation 2024;149:30–449.

see also: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator

Citation of prevent

prevent is not an official Stata command. It is a free contribution
to the research community, like a paper. Please cite it as such:

Linden, Ariel (2024). PREVENT: Stata module for computing AHA 10-year and 30-year risk of cardiovascular disease (atherosclerotic and heart failure)

Author

Ariel Linden

President, Linden Consulting Group, LLC

alinden@lindenconsulting.org

Acknowledgments

I would like to thank Rawan Ajeen for advocating that I write this package.

Also see

ascvd (if installed), framingham (if installed)