A JAMA study of 24,403 U.S. adults found the new PREVENT-ASCVD calculator shifts 22% into different cardiovascular risk categories, with about 14% moving lower and 7% moving higher.
The new tool drops race as an input and adds body mass index plus glycemia and kidney-disease markers, a change that generally lowers risk estimates for men, non-Hispanic Black adults and smokers while raising them for women and people with diabetes.
Risk buckets also changed: the borderline group grew to about 18% from 13%, the intermediate group fell to about 20% from 25%, and the high-risk share stayed near 11% to 12%.
Statin eligibility barely changed at around 50%, but more adults now land in the enlarged borderline group, where coronary artery calcium scans and shared decision-making may guide treatment.
An accompanying editorial said the revised guidance may sharpen risk assessment, but many eligible U.S. adults still go untreated or fail to reach LDL cholesterol targets.