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New Delhi: Heart attacks and strokes are often described as sudden, unpredictable events. But a large new study suggests that, in reality, the body almost always sends warning signals long before the first crisis strikes — and they are signs doctors already know how to detect.
Researchers analysing health data from more than nine million adults in South Korea and nearly 7,000 people in the United States found that over 99 per cent of patients who went on to suffer a heart attack, stroke, or heart failure had at least one major cardiovascular risk factor above healthy levels well in advance of their first event. The most common red flags were high blood pressure, raised cholesterol, elevated blood sugar, and smoking.
The findings, published in the Journal of the American College of Cardiology, challenge the long-held belief that heart disease often appears “out of the blue”. Instead, they suggest that most cases develop quietly over years, driven by risk factors that are measurable — and, crucially, modifiable.
Professor Philip Greenland of Northwestern University in Chicago, the study’s senior author, said the results were striking in their consistency. “Exposure to one or more non-optimal risk factors before cardiovascular events is almost universal,” he said. “The priority now is to focus on controlling these factors rather than chasing causes that are harder to treat or not clearly linked.”
Participants in the study underwent repeated health screenings over time, allowing researchers to track changes in blood pressure, cholesterol levels, blood sugar, and smoking habits years before any cardiac event occurred. High blood pressure emerged as the most widespread issue, present in more than 95 per cent of patients in South Korea and over 93 per cent in the US, before their first heart attack or stroke.
Notably, the pattern held even among women under 60 — a group often perceived to be at lower cardiovascular risk. More than 95 per cent of women in this age bracket had at least one warning sign before their first event.
The biological link has been established; well-persistent hypertension can damage artery walls and result in injuries that slowly accumulate fat deposits, a process known as atherosclerosis. Over time, narrowed or blocked arteries can trigger a heart attack or a stroke. High blood sugar, on similar lines, while smoking can make blood vessels more prone to clot formation and inflammation, while raising blood pressure and heart rate.
Heart diseases are a leading cause of death globally, and it claims 19.8 million lives each year, as per the WHO. While experts say that the message is clear - regular check-ups, avoiding alcohol intake, and smoking cessation to prevent heart-related deaths, it continues to be just as essential for all to take note of the symptoms and go for regular screenings as well.
