4 Health Warnings Before 99% of Strokes and Heart Attacks

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A recent study from Northwestern Medicine and Yonsei University in South Korea has revealed that heart issues are rarely sudden events. According to the research, nearly all individuals who experienced a heart attack, heart failure, or stroke had at least one of four specific risk factors before their health event occurred. More than 93% of those studied had two or more of these risk factors.

The findings were published in The Journal of the American College of Cardiology. Heart disease remains the leading cause of death globally, while stroke ranks as the fourth leading cause of death in the United States.

For this study, researchers analyzed up to two decades of health records involving over 9.3 million adults in South Korea and nearly 7,000 individuals in the U.S. These participants underwent multiple health screenings throughout the study period.

The researchers focused on identifying how many individuals had any of the following four nonoptimal risk factors prior to experiencing a heart-related event or stroke. “Nonoptimal” refers to levels that are not ideal but not yet alarming. The four risk factors include:

• Blood pressure greater than 120/80 mm Hg, or being treated for high blood pressure
• A total cholesterol level greater than 200 mg/dL, or being treated for high cholesterol
• A fasting glucose (sugar) level greater than 100 mg/dL, or having a diagnosis of or being treated for diabetes
• Past or current tobacco use

In addition, the researchers examined those with “clinically elevated” risk factors, defined as:

• Blood pressure greater than 140/90 mm Hg
• A total cholesterol level greater than 240 mg/dL
• A fasting glucose level greater than 126 mg/dL
• Current smoking

At least 90% of patients had at least one clinically elevated risk factor before their first cardiac event or stroke. High blood pressure was the most common risk factor, present in over 95% of patients in South Korea and over 93% in the U.S.

The good news is that these risk factors are modifiable, meaning they can be managed or reduced through lifestyle changes and medical intervention. Dr. Philip Greenland, professor of cardiology at Northwestern University, emphasized the importance of addressing these factors in his summary of the study findings:

“We think the study shows very convincingly that exposure to one or more nonoptimal risk factors before these cardiovascular outcomes is nearly 100%. The goal now is to work harder on finding ways to control these modifiable risk factors rather than to get off track in pursuing other factors that are not easily treatable and not causal.”

Understanding how heart health impacts overall well-being is essential. For example, certain heart conditions have been linked to dementia and declining brain health.

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