Most Individuals with Heart Attack and Stroke Risk Factors Show Warning Signs Before Events, Large Study Finds

A comprehensive analysis conducted by researchers from Northwestern University and Yonsei University in South Korea reveals that over 99% of individuals who experienced heart attacks, strokes, or heart failure had at least one risk factor above optimal levels well before their cardiovascular incident. The large-scale study examined health records spanning over a decade from more than 9 million adults in South Korea and nearly 7,000 in the United States, challenging the misconception that such life-threatening events occur suddenly without warning.

The research emphasizes the prevalence of modifiable risk factors, particularly high blood pressure, cholesterol, blood sugar levels, and tobacco use, which were present in the majority of cases prior to the health crises. High blood pressure was identified as the most common issue, affecting more than 93-95% of patients across both populations.

The findings underscore that these risk factors often go unnoticed and uncontrolled long before dangerous cardiovascular events happen. Remarkably, even among women under 60—a group thought to be at lower risk—over 95% exhibited at least one nonoptimal risk factor prior to adverse outcomes.

The study utilized definitions from the American Heart Association to classify nonoptimal levels, such as blood pressure ≥120/80 mm Hg, cholesterol ≥200 mg/dL, fasting glucose ≥100 mg/dL, or tobacco use. When analyzed at more elevated, clinically recognized levels, the pattern persisted, with at least 90% of individuals having at least one major risk factor before developing serious heart-related conditions.

According to senior author Dr. Philip Greenland, these results advocate for intensified efforts in controlling modifiable risk factors through lifestyle adjustments and medical interventions, aiming to prevent the progression to overt cardiovascular disease and reduce associated mortality worldwide.

For detailed findings, see the publication in the Journal of the American College of Cardiology. Source: https://medicalxpress.com/news/2025-09-factor-heart-failure-large-scale.html