Posted By Nicole Singh, MD | September 02, 2026
Knowing your personal cardiovascular risk can help us make a plan to protect your health before problems occur. This is an important part of your Personalized Health Program annual exam. The tools below provide useful information to support a thoughtful conversation about lifestyle, monitoring, and when appropriate, medication.
1. The PREVENT Risk Calculator
PREVENT stands for Predicting Risk of Cardiovascular Disease EVENTs. It is a newer American Heart Association tool that is validated for primary prevention in adults aged 30 to 79 years without known cardiovascular disease to estimate 10- and 30-year risk of cardiovascular disease.
PREVENT estimates the chance of heart attack, stroke and heart failure. The calculator uses the following health information: age and sex, blood pressure, cholesterol levels, diabetes status, smoking status, use of blood pressure or cholesterol medication, kidney function, and when available, it can also include your A1c, which reflects average blood sugar over about three months. Your estimated 10- and 30-year risk result is shown as a percentage and is not a prediction of your future with certainty. It is one tool that can help us decide how strongly to focus on lifestyle changes, blood pressure treatment, cholesterol treatment, and other preventive steps.
2. Lipoprotein(a), Also Called Lp(a)
Lp(a) is a lipoprotein particle that transports cholesterol in the blood. Your level is mostly determined by your genes and usually stays fairly stable throughout life. For this reason, it often only needs to be checked once. Most recent guidelines recommend measuring Lp(a) at least once in every adult.
A high Lp(a) level can increase the risk of heart attack, stroke, and narrowing of the aortic valve in the heart. Lp(a) adds risk beyond your usual cholesterol level and blood pressure. This means that some people may have more risk than expected even when other test results look reassuring. Testing may be especially useful if there is a family history of early heart attack or stroke. Standard lifestyle habits and statins do not lower Lp(a) very much, however, they are important in lowering your overall cardiovascular risk by improving other important risk factors. Medications designed specifically to lower Lp(a) are being studied but are not yet approved for general use.
3. Coronary Artery Calcium, or CAC, Score
A coronary artery calcium score is a brief, low-dose CT scan of the heart. It looks for calcium in the walls of the heart arteries. Calcium can be a sign of plaque buildup, also called atherosclerosis. The scan usually takes only a few minutes, there is no contrast dye and there is a small amount of radiation exposure. The result is called an Agatson score. A score of 0 indicates no detectable calcium. This often suggests a low near-term risk of a heart problem. A score above 0 indicates some plaque is present. Higher scores generally mean more plaque and greater risk. A score over 300 often suggests a substantially higher risk. A score of 0 does not rule out all heart disease. It also does not replace evaluation of symptoms. New chest pressure, shortness of breath, fainting, or other concerning symptoms should be discussed promptly. CAC testing is often most useful when a person’s risk is in an “in-between” range and it is unclear whether starting a statin or another preventive treatment would be beneficial. It can provide additional information to guide a shared decision. It is usually less helpful before age 40 because calcium in the heart arteries is less common at younger ages.
Each tool looks at a different part of cardiovascular risk:
- PREVENT score: Estimates your overall chance of heart attack, stroke, or heart failure based on common health information.
- Lp(a): Identifies an inherited source of risk that routine cholesterol testing may not show.
- CAC score: Shows whether plaque has already begun to build up in the heart arteries.
Together, these tools can help make prevention more personal and focused on what matters most for you.
