Evidence map›Paper›PMID 42086979›Full record

ArticleNature medicine2026

Multinational validation of the PREVENT and SCORE2 cardiovascular risk equations across 6.4 million individuals.

Brendon L Neuen, Rupert W Major, Morgan E Grams, Yingying Sang, Josef Coresh, Shoshana H Ballew, Aditya Surapaneni, Natalia Alencar de Pinho, Johan Ärnlöv, Clare Arnott and 43 more

Abstract readValidation Study
In one paragraph

Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

53 authors.

Brendon L Neuen *The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Rupert W Major *School of Medical Sciences - Public Health and Epidemiology Division (SAPPHIRE Group) College of Life Sciences, University of Leicester, Leicester, UK.
Morgan E GramsDivision of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA. ckdpc@nyulangone.org.ORCID http://orcid.org/0000-0002-4430-6023
Yingying SangOptimal Aging Institute, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
Josef CoreshOptimal Aging Institute, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA. josef.coresh@nyulangone.org.ORCID http://orcid.org/0000-0002-4598-0669
Shoshana H BallewOptimal Aging Institute, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.ORCID http://orcid.org/0000-0002-7547-3764
Aditya SurapaneniDivision of Precision Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA.
Natalia Alencar de PinhoCentre for Research in Epidemiology and Population Health (CESP), Clinical Epidemiology and Pharmacoepidemiology Team, Inserm U1018, Paris-Saclay University, Villejuif, France.
Johan ÄrnlövDepartment of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institute, Stockholm, Sweden.
Clare ArnottThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Samira BellDivision of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK.ORCID http://orcid.org/0000-0001-9100-1575
Jarett BerryDepartment of Medicine, The University of Texas at Tyler School of Medicine, Tyler, TX, USA.
Hermann BrennerCancer Prevention Graduate School, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0000-0002-6129-1572
Elizabeth CieminsAmerican Medical Group Association, Alexandria, VA, USA.
Alexander R ChangDepartment of Nephrology, Geisinger Medical Center, Danville, PA, USA.
Mary CushmanDepartment of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.ORCID http://orcid.org/0000-0002-7871-6143
James A de LemosDivision of Cardiology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Juan Miguel Diaz-TocadosVascular and Renal Translational Research Group, Biomedical Research Institute of Lleida, Dr. Pifarré Foundation (IRBLleida), RICORS 2024, Lleida, Spain.ORCID http://orcid.org/0000-0001-5192-5212
Alfredo E FarjatClinical Statistics & Analytics, Bayer BV, Hoofddorp, The Netherlands.
Robert A FletcherThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Ron T GansevoortUniversity Medical Centre Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-3223-0906
Hiddo J L HeerspinkDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-3126-3730
William G HerringtonRenal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-1172-8243
Chuan HongDepartment of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Edward J HorwitzDepartment of Medicine, Division of Nephrology & Hypertension, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Shih-Jen HwangFramingham Heart Study, Framingham, MA, USA.ORCID http://orcid.org/0000-0002-2129-5704
Simerjot K JassalVA San Diego Healthcare System and Division of General Internal Medicine, Department of Medicine, University of California, San Diego, San Diego, CA, USA.
Philip A KalraSalford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Ronit KatzDepartment of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0001-7723-7469
Sadiya S KhanDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID http://orcid.org/0000-0003-0643-1859
Csaba P KovesdyThe University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA.ORCID http://orcid.org/0000-0002-8204-911X
Florian KronenbergDepartment of Genetics, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria.ORCID http://orcid.org/0000-0003-2229-1120
Jennifer S LeesSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID http://orcid.org/0000-0001-6331-0178
Donald M Lloyd-JonesFramingham Center for Population and Prevention Science and Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Jose Geraldo MillDepartment of Physiological Sciences and Cassiano Antonio Moraes University Hospital (Hucam/Ebserh), Federal University of Espírito Santo, Vitória, Brazil.
David M J NaimarkFaculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Chiadi NdumeleJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA.
Kevan R PolkinghorneDepartment of Nephrology, Monash Medical Centre, Monash Health, Melbourne, Victoria, Australia.
Bruce M PsatyCardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-7278-2190
Patrick SchloemerClinical Statistics & Analytics, Pharmaceuticals, Bayer AG, Berlin, Germany.ORCID http://orcid.org/0009-0004-7787-5662
Michael G ShlipakKidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, San Francisco, CA, USA.
Prabin ShresthaThe University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA.
Zean SongDepartment of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Natalie StaplinRenal Studies Group, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-4482-4418
Dominik SteublBoehringer Ingelheim International GmbH, Ingelheim, Germany.
Priya VartDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, The Netherlands.
Frank L J VisserenDepartment of Vascular Medicine, Utrecht University, Utrecht, The Netherlands.
Mark WoodwardThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.ORCID http://orcid.org/0000-0001-9800-5296
Kazumasa YamagishiDepartment of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan.ORCID http://orcid.org/0000-0003-3301-5519
Bessie A YoungUW JEDI Center for Transformational Research, Office of Healthcare Equity, and Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA, USA.
Charumathi SabanayagamSingapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore and Duke-NUS Medical School, Singapore, Singapore.ORCID http://orcid.org/0000-0002-4042-4719
Jose M ValdivielsoVascular and Renal Translational Research Group, Biomedical Research Institute of Lleida, Dr. Pifarré Foundation (IRBLleida), RICORS 2024, Lleida, Spain.ORCID http://orcid.org/0000-0003-1343-0184
CKD Prognosis Consortium investigators

Funding

Chronic Kidney Disease Prognosis Consortium (CKD-PC)R01DK100446 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, Morgan Erika Grams · 2014 to 2026
$10.7M
NIDDK NIH HHS R01 DK100446U.S. Department of Health & Human Services | NIH | National Institute of Diabetes and Digestive and Kidney Diseases (National Institute of Diabetes & Digestive & Kidney Diseases) R01DK100446Wellcome TrustWellcome Trust (Wellcome) Early Career Award (301005/Z/23/Z)
6 · The paper itself

Abstract

The American Heart Association's PREVENT equations estimate risk of total cardiovascular disease (CVD), atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF) to guide lipid-lowering and blood pressure-lowering therapy in people ages 30-79 years in the United States. The SCORE2 risk algorithm is used to estimate CVD risk for similar purposes in people ages 40 and older in Europe. Neither set of equations has been comprehensively validated in global observational cohorts and randomized trials. In this study, in 44 observational cohorts and 18 randomized trials, we assessed discrimination and calibration of the two risk algorithms across geographical regions (North America, Europe and Asia/Other or multiregional trials). We also created scaling factors for risk prediction over 1-9 years using the PREVENT equations, enabling shorter-term risk prediction for research purposes or to facilitate clinical trial enrollment. Over 5.1 years of mean follow-up, 293,737 PREVENT total CVD events (fatal and non-fatal ASCVD or HF) and 258,086 SCORE2 CVD events (myocardial infarction, stroke or cardiovascular death) were observed among 6,422,714 and 5,437,384 individuals, respectively. Despite differences in CVD outcome definitions, target populations and predictor variables, overall discrimination and calibration were similar for both equations, with generally good performance across regions, including in multiregional randomized trials. These findings lend support for adoption of PREVENT or SCORE2 for cardiovascular risk stratification across diverse settings.

Indexed as

Cardiovascular DiseasesAdultAgedAlgorithmsEuropeFemaleHeart Disease Risk FactorsHeart FailureHumansMaleMiddle AgedPrediction AlgorithmsRisk AssessmentRisk FactorsUnited States

Identifiers

PMID42086979
PMCPMC13375529

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.