Ten- and thirty-year cardiovascular disease risks using PREVENT equation in Koreans from 2001 to 2021

BACKGROUND: Cardiovascular disease (CVD) remains a major global health burden, with risk factors evolving alongside socioeconomic and lifestyle changes. The PREVENT equation provides race-free estimates of 10- and 30-year CVD risk, but its utility in Asian populations remains underexplored. This study assessed long-term trends in CVD risk among Korean adults and identified key contributing factors. METHODS: This cross-sectional analysis used nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES), spanning 2001-2021. Adults aged ≥30 years with relevant clinical and laboratory data were included. The PREVENT equation was used to calculate 10- and 30-year CVD risk. Trends in risk estimates were examined by year and sex. RESULTS: The estimated 10-year risk of total CVD increased from 4.6% ± 7.1% (mean ± SD) in 2001 to 7.9% ± 9.0% in 2021, and the estimated 30-year risk for total CVD climbed from 15.8% ± 14.6% to 22.9% ± 14.5% over the same period. Key contributors to this upward trend included worsening glycemic control (mean glucose: 97 ± 17 mg/dl in 2001 vs 103 ± 22 mg/dl in 2021) and increased antihypertensive medication use. In contrast, rising high-density lipoprotein cholesterol levels and declining male smoking rates (47.9% in 2001 to 28.9% in 2021) may have mitigated some risk. CONCLUSIONS: Over two decades, estimated CVD risk has increased in the Korean population, highlighting the need for targeted prevention efforts. As countries undergo rapid economic and demographic transitions, long-term CVD risk estimation using the PREVENT equation may inform public health strategies to mitigate cardiovascular burden.