Nearly everyone who experiences a cardiovascular event — heart attacks, heart failure and strokes — exhibits at least one modifiable risk factor beforehand, new research shows.
The study refutes the notion that these events happen without warning. Researchers found that nearly 100% of people who experienced cardiovascular events over the course of 20 years were either current or former smokers, or they had suboptimal levels of blood pressure, blood glucose or cholesterol.
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The researchers concluded that greater scrutiny of these issues could prevent cardiovascular events.
The study, published Monday in the Journal of the American College of Cardiology, analyzed data from 600,000 cardiovascular disease cases in South Korea and another 1,200 from the United States.
The researchers looked at how frequently these patients had risk factors that were outside of the American Heart Association's definition of a healthy range, but not so severe as to require clinical treatment, classifying these suboptimal.
Though these aren't always considered red flags to medical providers, the researchers found that more than 99% of people who experienced cardiovascular events had at least one suboptimal risk factor and more than 93% had two or more.
These findings were consistent among South Koreans and Americans, and no matter the patient's type of cardiovascular event, age or gender. Even among women under the age of 60 — often assumed to be at the lowest risk for cardiovascular events — more than 95% of patients had at least one suboptimal risk factor.
Suboptimal blood pressure, considered to be anything greater than or equal to 120/80 mm Hg, was the most common risk factor.
The study's results point to a need for investment in early detection efforts to prevent serious heart conditions, Dr. Philip Greenland, a preventive cardiologist at Northwestern University Feinberg School of Medicine and co-author of the report, told Northwestern Now.
"We think the study shows very convincingly that exposure to one or more non-optimal risk factors before these cardiovascular outcomes is nearly 100%," he said. "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."
Managing lifestyle factors like sleep habits, stress and depression in combination with the four risk factors included in the study likely yields the best chance to avoid serious heart disease risk, Dr. Ahmed Tawakol, a cardiologist at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School, told CNN. He was not involved in the research.
"I'm hoping that the more we double down and show the efficacy of treating all these things together, that more people will combine these approaches and actually enjoy much longer health spans," he said.