Associations between the American Heart Association PREVENT cardiovascular disease risk equation and abdominal aortic calcification: a cross-sectional study

Abdominal aortic calcification (AAC) is a recognized marker of cardiovascular disease (CVD) risk. Although the American Heart Association (AHA) PREVENT equation has been developed to estimate 10-year CVD risk, its relationship with AAC remains unclear. The PREVENT equation integrates demographic, clinical, and behavioral risk factors to estimate CVD risk, while AAC reflects underlying atherosclerosis and vascular calcification. Exploring their association may provide insights into the linkage between predicted cardiovascular risk and subclinical vascular damage. This cross-sectional study included 2,660 participants from the 2013–2014 National Health and Nutrition Examination Survey. Ten-year CVD risk was estimated using the PREVENT equation, and associations were examined using weighted multivariable logistic regression and restricted cubic spline (RCS) models. After full adjustment, each 1% increase in the 10-year CVD risk score was significantly associated with higher odds of AAC (OR = 1.05, P = 0.016) and severe AAC (OR = 1.11, P = 0.006). Compared with the < 5% risk group, the ORs for severe AAC were 9.27 and 27.1 in the 7.5% -< 20% and ≥ 20% risk groups, respectively (P < 0.05). Subgroup analyses indicated stronger associations in non-Hispanic Whites and never smokers, and sensitivity analyses confirmed the robustness of the findings. RCS analyses demonstrated a linear association between the 10-year CVD risk and AAC score, and nonlinear relationships with moderate and severe AAC. The PREVENT-estimated 10-year CVD risk is significantly associated with AAC, suggesting that AAC may serve as an important marker of subclinical vascular damage.