More than 99% of people who suffer a heart attack, stroke, or heart failure have at least one risk factor beforehand—yet many have no idea until it’s too late. That has made heart disease the leading cause of death in the U.S. since at least 1950. Now, researchers hope a new generation of tools can help people identify these invisible warning signs before tragedy strikes.
A study published in 2025 in the Journal of the American College of Cardiology introduced a free online calculator that estimates a person’s 30-year risk of developing heart disease. Designed for adults aged 30 to 59, the calculator encourages annual use and is based on the American Heart Association’s PREVENT equations. It updates an older tool that predicted only 10-year risk and largely excluded younger adults, many of whom later experienced heart attacks.
The calculator takes into account key metrics such as age, sex, body mass index, blood pressure, cholesterol levels, smoking status, and diabetes history. Users receive both 10-year and 30-year risk estimates for heart disease, including the likelihood of developing heart failure.
Dr. Sadiya Khan, senior study author and professor of cardiovascular epidemiology at Northwestern Medicine, said the goal is to start conversations about prevention earlier. “We know that more and more young adults are facing obesity, diabetes, or hypertension, and we want to make sure we’re starting that conversation early, so we’re not waiting until someone has a heart attack or presents in heart failure,” she said.
Cardiologists see the tool as a complement to regular medical care, not a replacement. Dr. Nishant Shah, a preventive cardiologist at Duke University Medical Center, encourages patients to use the calculator to spark discussions about lifestyle changes and preventive measures. “Talking about these things with patients before a problem happens is crucial,” he said. “After patients learn their heart disease risk score, we discuss exercise, diet, sleep, medications like statins, and regular monitoring of blood pressure and cholesterol.”
Experts note that risk calculators cannot capture every factor. Dr. Matthew Tomey, a cardiologist at Mount Sinai Fuster Heart Hospital, said genetic risks, artery calcification, inflammation, and lifestyle patterns are not fully reflected in the PREVENT model. “These scores are only fruitful if they motivate you to make healthy choices,” he said. “Otherwise, it’s just a number.”
Other assessments, such as coronary artery calcium scans, can help identify early disease, and doctors often use multiple tests alongside family history and lifestyle evaluation to give a more complete picture. Dr. Luke Laffin, a preventive cardiologist at the Cleveland Clinic, said the PREVENT calculator is a contemporary tool that complements other methods of risk assessment.
By turning hidden risks into visible data, the calculator offers people a chance to act early, potentially preventing heart attacks, strokes, or heart failure. “Everyone should have their cardiovascular risk calculated,” Laffin said. “Understanding your risk can guide conversations with your doctor and help you take meaningful preventive action.”
