Heart Disease Is Preventable. So Why Does It Kill So Many of Us?

The evidence for what causes most cardiovascular disease today is very clear. A recent study that my colleagues and I published in 2025 identified that more than 99% of people who had a heart attack, stroke, or heart failure had at least one cardiovascular risk factor in the years prior. These results leave no doubt that unlike many other diseases, cardiovascular disease is preventable. But we keep failing to recognize and treat risk factors earlier, such as hypertension, high cholesterol, diabetes, chronic kidney disease, and tobacco use. 

What if we could, years or decades before, predict the likelihood that a cardiovascular event may happen? In fact, we can: the science, data, and tools are now available to do just this. A few years ago, my colleagues and I led an effort for the American Heart Association to develop the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations, a new calculator released in 2023 to predict risk for cardiovascular disease. The PREVENT equations can predict a person’s risk for having a heart attack, stroke, or heart failure over the next 10 or 30 years. This calculator is now endorsed by the most recent national guidelines for cholesterol and blood pressure management released by the American Heart Association, the American College of Cardiology, and collaborating societies. These guidelines recommend clinicians use the PREVENT calculator for patients ages 30 to 79 to estimate their risk of cardiovascular disease.