Nearly All Heart Attacks and Strokes Linked to Modifiable Risk Factors, Landmark Study Reveals
BOSTON, MA – February 29, 2024 - A sweeping global study has found that 99% of cardiovascular disease events, including heart attacks and strokes, are linked to just four modifiable risk factors: high blood pressure, high cholesterol, high blood sugar, and tobacco use. The research, published in The Journal of the American College of Cardiology, challenges the notion that heart disease often strikes without warning and underscores the critical importance of preventative health measures.
The study analyzed data from the United States and the United Kingdom, revealing that high blood pressure was the most prevalent risk factor, preceding over 93% of cardiovascular events in both countries. Researchers emphasize that hypertension frequently goes undiagnosed or untreated, notably among younger adults who do not routinely monitor their blood pressure.
“The goal now is to work harder on finding ways to control these modifiable risk factors rather than to get off track in pursuing othre factors that are not easily treatable and not causal,” stated Dr. Greenland, a researcher involved in the study.
The findings reinforce the American Heart Association’s “Life’s Essential 8” framework, which advocates for maintaining optimal levels of blood pressure, cholesterol, and blood sugar, alongside complete avoidance of tobacco.
According to the study’s authors, “These results not only challenge claims that coronary heart disease events frequently occur without antecedent major risk factors but also demonstrate that other cardiovascular disease events, including heart failure or stroke, rarely occur in the absence of nonoptimal conventional risk factors.”
Experts emphasize a need to redefine “healthy,” moving beyond simply avoiding unhealthy levels to actively pursuing optimal health metrics.duke University cardiologist Neha Pagidipati, who was not involved in the research, wrote in an accompanying editorial, “We can – and must – do better.”
The study’s conclusions are particularly timely given rising global rates of hypertension, diabetes, and obesity, according to the World Health Organization. with 99% of cardiovascular disease potentially attributable to these modifiable factors, researchers suggest millions of lives could be saved through proactive prevention.
The findings appeared in The Journal of the American College of Cardiology (DOI: 10.1016/j.jacc.2025.07.014).
