A recent analysis of health records from South Korea and the United States found that 99 percent of heart attacks and strokes were preceded by at least one common risk factor. This was consistent across various age groups in both countries.
Among the prominent risks identified were high blood pressure, high cholesterol, high blood sugar, and tobacco use. These conditions contribute significantly to cardiovascular diseases, which impact the heart and blood vessels.
Examining heart health risks
This research, led by Hokyou Lee, MD, PhD, at Yonsei University College of Medicine in Seoul, highlights the importance of understanding cardiovascular risks and prevention strategies in various populations.
The study analyzed two groups: one from a national insurance database in Korea and another from a diverse cohort in the United States. Together, they covered health records from over 9 million adults, observing many initial heart-related or neurological events.
Of those who experienced a first event, 601,025 outcomes were noted in the Korean group, while the U.S. group had 1,188. Researchers then examined whether any of the four risk factors appeared during clinic visits prior to the events.
They didn’t require formal diagnoses for risk classification, reflecting real-world healthcare scenarios. Quite a few individuals might have concerning numbers for years before the onset of diseases.
The four heart risk factors
The study defined hypertension as chronically elevated blood pressure—specifically, systolic readings of 120 mm Hg or diastolic at 80 mm Hg. Individuals on blood pressure medication were also classified as having this risk.
Cholesterol levels were categorized as concerning if total cholesterol was at or above 200 milligrams per deciliter or if an individual used a lipid-lowering drug. Additionally, fasting glucose (blood sugar after an 8-hour fast) at or above 100 milligrams per deciliter was included.
The fourth risk factor was past or present tobacco use. Interestingly, high blood pressure often showed up before heart-related events, whereas smoking was less frequently noted.
Healthcare providers usually emphasize lowering LDL cholesterol, the particle most strongly linked with arterial plaque buildup. Reducing LDL levels can concretely diminish future heart attack risks.
Understanding when non-ideal is harmful
The thresholds established in the study were intentionally set low to identify risks early. This mindset, known as primordial prevention, focuses on stopping harmful factors from developing into diseases.
When blood pressure, glucose, or lipid levels are consistently high, damage to arteries accumulates over time. The body can usually handle minor fluctuations, but continuous exposure results in increased risk of serious health issues.
Many navigate daily life with numbers that aren’t alarming at first glance but still fall outside the safest range. These small discrepancies can put pressure on the heart and blood vessels before they eventually weaken.
Routine checkups are crucial, as they can reveal these early signs. Addressing problems while they are still mild could lead to better long-term health outcomes and potentially prevent emergencies down the line.
Women under the age of 60 are not exempt
In women younger than 60, over 95 percent of heart failure and stroke events were still preceded by at least one non-ideal risk factor. This suggests that early preventive measures are critical, even among the lowest risk female demographic.
This finding challenges the notion that midlife crises arise suddenly in otherwise healthy women and emphasizes the need for ongoing management of blood pressure, cholesterol, and glucose throughout adulthood.
The disconnect between risk and care
An associated study indicated that individuals typically had several clinic visits prior to experiencing events, providing numerous chances for health risk assessment and management. Those visits offered opportunities to test, treat, and follow through.
Controlling blood pressure, lowering cholesterol, quitting smoking, and managing glucose levels are all achievable goals today. A combination of therapeutic interventions and gradual lifestyle changes can yield significant improvements.
Cardiovascular disease continues to be the leading cause of death in the United States, with 941,652 fatalities reported in 2022, according to the American Heart Association. This stark reality highlights the urgent need for early detection and management of these four risk factors.
While the findings do not guarantee that every event can be prevented, they do suggest that enhancing control over these common risks could prevent a considerable number of tragedies.
Identifying heart health risks
This was an observational study, meaning it tracked individuals without assigning specific treatments. Therefore, it reveals patterns but cannot definitively establish cause. Nevertheless, it provides clear insights into where preventive efforts should focus.
The diverse cohorts came from varying backgrounds, and clinic visits were spread out over several years. Even with these differences, the main patterns remained consistent.
Looking ahead, future research will explore methods to engage people earlier and maintain controlled health metrics over time. Accessibility to primary care, community initiatives, and user-friendly medications will all be essential in this process.
The study is published in the Journal of the American College of Cardiology.
