OVER 99% of adults who develop coronary heart disease, stroke, or heart failure already have at least one risk factor before their first event, according to an international study.
Coronary Heart Disease and Major Risk Factors
Coronary heart disease remains a leading cause of death worldwide, and identifying those at heightened risk has been a major focus in public health. In this large-scale study, researchers tracked more than 9 million South Korean adults and nearly 7,000 U.S. participants for up to two decades, examining blood pressure, cholesterol, glucose, and tobacco use.
Patterns and Prevention Gaps
The results showed that almost every person who later suffered a coronary heart disease event had at least one risk factor, such as raised blood pressure, high cholesterol, raised blood sugar, or a history of tobacco use, often long before symptoms developed.
The prevalence of risk factors was consistent across age, sex, and national cohorts. High blood pressure was the most common, present in over 95 percent of patients, even among younger women often assumed to be at lower risk. When using stricter clinical criteria, more than 90% of individuals still met the definition for at least one major risk factor before their episode. Researchers also found that over 93% had two or more risk factors, suggesting that coronary heart disease acts on a long background of slowly accumulating modifiable risks.
Reducing Coronary Heart Disease with Prevention
The findings call for a renewed push to detect and treat the key drivers of coronary heart disease well before symptoms arise. Effective blood pressure management, cholesterol and glucose control, and reducing tobacco use must be priorities in both clinical practice and public policy. Focusing on these modifiable risk factors could dramatically cut rates of coronary heart disease and related complications worldwide as part of a wider commitment to prevention and healthy living
Reference
Lee H et al. Very high prevalence of nonoptimally controlled traditional risk factors at the onset of cardiovascular disease. JACC. 2025;86:14.
