A groundbreaking study reveals a startling connection: 99% of heart attacks and strokes are linked to just four key risk factors. This comprehensive research, involving health data from over 9 million adults in South Korea and the US, highlights the critical role these factors play in cardiovascular health. The study, published in 2025, emphasizes the importance of managing these risk factors to prevent serious heart-related events.
The four major risk factors identified are high blood pressure, high cholesterol, high blood sugar levels, and tobacco smoking (past or current). When considered together, these factors were present in a staggering 99% of all cardiovascular events during the long-term study. Even in women under 60, who typically have a lower risk of cardiovascular events, over 95% of heart attacks or strokes were linked to one of these risk factors.
High blood pressure emerged as the most prevalent factor associated with cardiovascular events. In both the US and South Korea, a concerning 93% of individuals who experienced heart attacks, strokes, or heart failure had hypertension beforehand. This finding underscores the potential for managing hypertension to be a powerful tool in preventing serious cardiovascular disease.
Philip Greenland, a senior author and cardiologist from Northwestern University, emphasized the significance of the study's findings. He stated, 'We think the study shows very convincingly that exposure to one or more nonoptimal risk factors before these cardiovascular outcomes is nearly 100 percent.' Greenland's focus is on targeting modifiable risk factors for better cardiovascular health outcomes.
The study's results challenge recent claims that insidious cardiovascular events occurring without risk factors are on the rise. Greenland and his co-authors suggest that previous studies may have missed diagnoses or overlooked risk factor levels below the clinical diagnostic threshold. This highlights the need for more comprehensive risk assessments.
Neha Pagidipati, a cardiologist at Duke University, echoed the importance of proactive risk management in an accompanying editorial. She stated, 'We can – and must – do better.' This sentiment underscores the potential for improved cardiovascular health outcomes through early intervention and risk factor management.
The study's publication in the Journal of the American College of Cardiology further emphasizes the importance of these findings. This research serves as a reminder that managing these four key risk factors is crucial in preventing heart attacks and strokes, ultimately improving overall cardiovascular health.
