99% of patients had major risk factors before first heart attack or stroke, study finds

September 30, 2025 by News Desk

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A large study has found that nearly 99 per cent of people who suffered a heart attack, stroke, or heart failure had at least one major risk factor beforehand, challenging the notion that these events often strike without warning.

The research, conducted by Northwestern Medicine, US, and Yonsei University, South Korea, analyzed health data from over 9.3 million Korean adults and nearly 7,000 US adults tracked for up to two decades.

The study focused on four major cardiovascular risk factors: blood pressure, cholesterol, blood sugar, and tobacco use. Findings revealed that more than 93 per cent of patients had two or more nonoptimal risk factors before their cardiac event, with high blood pressure being the most prevalent—affecting over 95 per cent in South Korea and over 93 per cent in the US.

Even women under 60, often considered lower risk, showed that over 95 per cent had at least one nonoptimal factor prior to heart failure or stroke. A secondary analysis using clinically elevated thresholds still found that at least 90 per cent of patients had one major risk factor.

Dr. Philip Greenland, senior author and professor of cardiology at Northwestern University, said, “The goal now is to focus on controlling these modifiable risk factors rather than pursuing other factors that are less treatable and not causal.”

The study was published in the Journal of the American College of Cardiology, highlighting the importance of early detection and management of key cardiovascular risk factors to prevent major cardiac events.