Abstract Body: Background: The Predicting Risk of CVD EVENTs (PREVENT) equations were developed with minimal representation from Hispanic/Latino adults.

Objective: To describe the ten-year risk of total cardiovascular disease (CVD) using PREVENT and estimate the discordance rate in Hispanic/Latino adults.

Methods: The Hispanic Community Health Study/Study of Latinos is a population-based cohort of 16,415 diverse Hispanic/Latino adults aged 18-74 from four urban communities (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA). At baseline (2008-2011), participants underwent a comprehensive examination which included questionnaires, anthropometric measurements, and fasting blood draws. Among 4,829 participants 30-79 years of age, without a history of CVD, examined in 2008-2009 and followed through 2019 (at least ten years), we used baseline information on age, sex, blood lipids, systolic blood pressure, body mass index, estimated glomerular filtration rate, diabetes status, smoking status, and anti-hypertensive or lipid lowering medication use, to calculate ten-year risk of total CVD (heart disease, stroke, or heart failure) using the base model PREVENT equation. CVD events were adjudicated from hospital records by an independent panel of clinicians through Dec 2019. We calculated the ten-year risk of total CVD using the base PREVENT equation. These analyses were weighted and accounted for the complex survey design of the study. We then calculated the discordance rate by comparing the predicted to observed number of CVD events overall and according to sex.

Results: In a diverse sub-population of HCHS/SOL, the mean age was 47.3 years, and 52.0% were female. Using the PREVENT equation, the mean ten-year CVD risk score was 5.2%; and 67.9% had a <5.0% risk of CVD; 9.0% had a 5 to <7.5% risk of CVD, 5.7% had a 7.5 to <10.0% risk of CVD, 8.6% had a 10.0 to <15.0%, 4.1% had a 15.0 to <20.0% risk of CVD, and 4.7% had a ≥20% risk of CVD. Over ten years, 224 CVD events were predicted, and 110 CVD events were observed (discordance rate: 103.6%). Men compared with women had higher risk of CVD (5.7% vs. 4.8%, p<0.05) and CVD was more likely to be overpredicted among males (discordance rate: 178.6%) than females (discordance rate: 55.9%).

Conclusion: In this diverse sample of Hispanic/Latino adults, the base PREVENT equation for total CVD overestimated risk of CVD, especially among males. These data identify a potential limitation of the PREVENT equation for Hispanic/Latinos adults.