A major new study reinforces a critical message for heart health: Almost every heart attack, stroke, or case of heart failure is preceded by traditional, manageable risk factors.
The research, published Monday in the Journal of the American College of Cardiology, found that in over 99% of the cardiovascular disease (CVD) cases analyzed, patients had at least one common risk factor—such as elevated blood pressure, blood sugar, cholesterol, or a history of smoking—before the event occurred.
Beyond Diagnosis: The Real Risk
The findings challenge some previous research suggesting a growing number of heart disease cases may have no known precursors. The difference in this study, according to experts, lies in its methodology.
Researchers analyzed medical data from two large patient groups—over 600,000 cases in South Korea and 1,000 in the U.S.—and did not rely solely on a formal diagnosis of a condition like diabetes or high blood pressure.
Instead, they looked at patients’ actual lab values and health data over time. This approach showed that even if a patient hadn't been formally labeled as having high blood pressure, their numerical levels often indicated a real, identifiable risk.
According to lead author Dr. Philip Greenland, a professor at Northwestern, even "mild" increases in these four areas must be treated with lifestyle adjustments or medication.
The Power of Prevention
The study strongly suggests that by proactively managing these established risk factors, doctors and patients can mitigate the risk for nearly all cases of severe heart disease.
“This research is particularly important because it reinforces that doctors and patients can manage the risk factors for almost all cases of heart disease,” noted Dr. Susan Cheng, a professor of cardiology at Cedars-Sinai Medical Center, who was not involved in the study.
This reinforces the long-standing medical consensus: the best strategy for prevention is to continue encouraging the management of these four key, modifiable factors.
Reframing Heart Health as Longevity
While the knowledge of how to prevent heart disease has been consistent, implementing changes remains a challenge. Experts suggest a shift in perspective is needed to motivate patients.
Adding medications or protocols to manage risk factors can often feel associated with the aging process, which can be unappealing. However, managing blood pressure, sugar, and cholesterol should instead be viewed as steps toward longevity, according to Dr. Ahmed Tawakol, a cardiologist at Massachusetts General Hospital.
He reframes the actions as steps toward longevity, arguing they aren't about losing anything but about gaining more years of health to do the things that matter.
Lifestyle Matters
Beyond the clinical factors, experts emphasize the importance of healthy behaviors for a comprehensive prevention strategy.
- Sleep, exercise, nutrition, and maintaining a healthy weight are essential for lowering CVD risk.
- Stress and depression are also potent risk factors, sometimes as powerful as smoking or diabetes.
With technology making it easier to track health at home—such as using a personal blood pressure cuff—patients are encouraged to work closely with their doctor to manage their unique risk profile.
"I’m hoping that as we more clearly show the success of tackling all these health factors at once, more people will adopt these combined approaches and truly gain longer, healthier lives," Dr. Tawakol added.
Disclaimer: This content is published only for health awareness and informational purposes. It's not a substitute for your professional medical advice. You must consult a doctor/healthcare professional regarding your specific health concerns.
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