A new large-scale study has confirmed that heart attacks and strokes almost never occur without warning. Researchers examined medical records of more than 9 million adults in the United States and South Korea, uncovering that nearly all individuals who suffered a major cardiovascular event had at least one of four key risk factors beforehand.
The Four Major Heart Attack Risk Factors
According to the study, 99% of heart attacks, strokes, and serious cardiac events were linked to one or more of the following conditions:
- High blood pressure
- High cholesterol
- Elevated blood sugar
- Tobacco smoking (past or present)
Even among women under 60, typically considered a lower-risk group, over 95% of heart-related emergencies were tied to these same risk factors, as reported by ScienceAlert.
High Blood Pressure Identified as the Biggest Threat
The analysis revealed that hypertension was the most widespread risk factor. More than 93% of patients who suffered heart attacks, strokes, or heart failure had a history of high blood pressure in both countries studied. Experts say this highlights the urgent need to properly manage blood pressure to prevent severe cardiovascular complications later in life.
Cardiologist Philip Greenland of Northwestern University noted that the study provides strong evidence:
“Exposure to one or more nonoptimal risk factors before cardiovascular outcomes is nearly 100 percent.”
He stressed that efforts must focus on controlling these modifiable risk factors rather than exploring less proven or untreatable causes.
Challenging the Myth of ‘Heart Attacks Without Warning’
The researchers explained that claims about increasing cases of heart attacks among people with no risk factors are likely due to misdiagnosed conditions or overlooked mild risk levels in earlier studies.
In an accompanying editorial, Duke University cardiologist Neha Pagidipati urged for stronger preventive measures, stating:
“We can – and must – do better.”
She emphasized that addressing health risks early can significantly reduce the burden of heart disease. The study was published in the Journal of the American College of Cardiology.