The New Way to Predict Your Risk of a Heart Attack

More than 99% of people who suffer a heart attack, stroke or heart failure have at least one risk factor beforehand, but many have no idea until it’s too late. That’s part of the reason why heart disease has been the leading cause of death in the United States since at least 1950. Now, scientists hope that a new generation of tools, like the first risk calculator of its kind, can turn these invisible warning signs into something people can see, understand and act on years before the worst-case scenario occurs.

“It’s a disease that is influenced by the choices we make in life. And I think we, as humans, can make wiser choices if we understand our risk – and perhaps even more importantly, if we understand the connection between risk and the choices we make,” says Dr. Matthew Tomey, a cardiologist at Mount Sinai Fuster Heart Hospital. “Understanding and communicating risks are extremely difficult things to do, and it’s particularly difficult for younger, well-feeling people. »

Here’s a look at the new science of cardiac risk prediction and the challenges that remain.

A new way to assess risks earlier

In a study published in 2025 in the Journal of the American College of CardiologyResearchers have introduced a free online calculator that calculates a person’s 30-year risk of developing heart disease. It is designed for adults ages 30 to 59 and should ideally be used once a year, says Dr. Sadiya Khan, lead author of the study and professor of cardiovascular epidemiology at Northwestern Medicine.

The new calculator, based on the American Heart Association’s PREVENT equations, is an update to an older tool that estimated a person’s 10-year risk of a first event of atherosclerotic cardiovascular disease, such as a heart attack or stroke. The old version was aimed at people aged 40 or over, and research found it often failed to identify a significant proportion of people who ended up having a heart attack.

Learn more: What to do if your high cholesterol is genetic

In addition to including younger adults and predicting longer-term predictions, the new model predicts a broader range of outcomes, including heart failure.

“It’s really about trying to push the boundaries of prevention by starting earlier,” says Khan. “We know that more and more young adults are facing obesity, diabetes or hypertension, and we want to make sure we start that conversation as early as possible, so we’re not waiting until someone has a heart attack or goes into heart failure.”

The calculator is simple, provided you have the key health indicators on hand. Users enter data such as gender, age, body mass index, blood pressure, cholesterol, smoking and diabetes history, and then, based on this snapshot of their current stats, they are given a 10-year and 30-year risk percentage of developing heart disease.

The benefit of acting quickly

Many experts view the new online calculator as a promising addition to the repertoire of tools available to help prevent heart disease. It aims to inspire conversations with clinicians, not replace care — an important distinction, says Dr. Nishant Shah, a preventive cardiologist at Duke University Medical Center.

The earlier these conversations start, the better, Shah says. He starts talking to people about their risk for heart disease around age 18, especially if they have a serious family history of the disease. Easy-to-access online tools, like the calculator, can open the door to these conversations and meaningful change. “It is crucial to discuss these topics with patients before a problem arises,” he says. Once patients know their heart disease risk score, it informs them about preventative measures they can take, such as exercising regularly, following a good diet, getting enough sleep, starting a medication like a statin if warranted, and keeping up with blood pressure and cholesterol tests. “These are all very important things to avoid a surprise,” he says. “A story I hear a lot is, ‘He or she was just fine yesterday, and today they woke up dead.’ This is what we are trying to avoid.

One of the main reasons why risk prediction tools can be so useful is that many people are simply unaware of their risk of developing heart disease. “A lot of these risk factors are silent,” says Shah. “Someone might have high blood pressure and won’t feel the effects until it gets very high. People don’t feel like anything is wrong; it’s different than a rash on the face.” For some people, he adds, simply quantifying the risk is enough to commit to protecting their heart and potentially saving their life.

Persistent pain points

No risk assessment will ever be able to perfectly predict a person’s risk of having a cardiac event.

“By necessity, there is no risk calculator that incorporates all the relevant variables,” says Tomey. “The PREVENT equations are a truly admirable advance in risk prediction, but they are parsimonious in the number of variables and the nature of the variables they include.”

Other relevant factors, he says, include whether a person has coronary artery calcification or plaque in an artery; genetic risks; high levels of lipoprotein (a); and measures of inflammation, including C-reactive protein. It also doesn’t take into account most lifestyle factors, like exercise and sleep quality. All of these “could be significant asterisks in whatever number you get from the calculator,” says Tomey, whose research has found that PREVENT equations underestimate risk in some people. “We cannot be satisfied with results like this,” he said. “It’s really important to understand the value they provide, but they’re not some sort of guarantee of protection if you have a lower score.”

Additionally, risk scores in general resonate differently depending on the person. Some people take them seriously, while others ignore them or misunderstand them. These scores “are only successful to the extent that they motivate you to make healthy choices,” says Tomey. If knowing your risk score inspires you to take stock of your daily choices and how you can improve your health, then “this is something that can significantly improve individual health and public health.” Otherwise, it’s just a number.

A multi-pronged approach

There are also other ways to predict heart risk. Some people benefit from knowing their coronary artery calcium score, for example, which is produced by a low-dose CT scan that detects calcium buildup in the heart’s arteries. This test can help diagnose coronary heart disease early and is often recommended for people with a family history of the disease.

Compared to a risk calculator, “neither is superior,” says Dr. Luke Laffin, a preventative cardiologist at the Cleveland Clinic. “They are complementary.”

In practice, doctors rarely rely on a single test. Regular health exams and labs are always informative, and some people benefit from stress tests, echocardiograms, and advanced lipid tests, such as for lipoprotein(a) and apolipoprotein B. Clinicians can also assess risk by taking a thorough family history and understanding lifestyle patterns.

Learn more: 9 Weird Symptoms Cardiologists Say You Should Never Ignore