Summary

•Main findings: our review of 35 cardiovascular risk apps showed that many apps are not aligned with validated risk scores or are not meant for healthcare professionals. Only one-third received high quality ratings. Top apps include “ASCVD Risk Estimator Plus” and “ESC CVD Risk Calculation,” noted for their high functionality and quality. The app landscape changes rapidly, so these findings may evolve. •App comparison: “ASCVD Risk Estimator Plus” and “ESC CVD Risk Calculation” are the top apps, with “ASCVD” offering flexibility and detailed risk scenarios, while “ESC” includes environmental factors and European risk calculators. “MDCalc Medical Calculator” is useful but lacks some features for shared decision-making. •Clinical implications: choose apps based on specific needs, like comprehensive prevention or flexible risk calculation. Language support and guideline alignment are important

Reflections

•Clinical relevance: high-performing apps like “ASCVD Risk Estimator Plus” can improve patient engagement and decision-making. There's a need for more high-quality, language-diverse apps. •Limitations: we faced challenges like rapid app updates and evaluation by non-specialists. Future research should address these gaps and assess how apps impact clinical practice. •Future directions: we need updated guidelines for app quality and functionality. Future work should focus on creating interactive apps and assessing their real-world impact