1st-Time Heart Failure or Stroke Patients Display 4 Specific Signs, Study Says

At least one person dies from cardiovascular disease every 34 seconds in the United States.

A doctor and emergency room nurse care for a patient at Mission Community Hospital in Panorama City, Calif., on Jan. 28, 2009. David McNew/Getty Images

More than 99 percent of people who suffered coronary heart disease (CHD), heart failure, or stroke for the first time had at least one risk factor for such events, according to a peer-reviewed study published on Sept. 29 in the Journal of the American College of Cardiology.

Researchers analyzed data of more than 9.34 million individuals from South Korea and 6,803 from the United States. They looked for four risk factors at nonoptimal levels before the first CHD, heart failure, or stroke events: blood pressure, glucose, cholesterol, and tobacco smoking.

The study specifically looked at the occurrence of the following conditions preceding the medical issues, irrespective of gender: blood pressure exceeding the 120/80 mm Hg level or BP-lowering treatment, total cholesterol higher than 200 mg/dL or lipid-lowering treatment, fasting glucose higher than 100 mg/dL or glucose-lowering treatment or diagnosis of diabetes, and past or current smoking.

Researchers found that among Koreans with CHD, 99.7 percent had at least one risk factor at a nonoptimal level, according to the study. This figure was 99.6 percent for Americans.

Similar patterns were seen in heart failure (HF), with 99.4 percent of Koreans and 99.5 percent of Americans having at least one nonoptimal risk factor. For stroke, these numbers were at 99.3 percent for Koreans and 99.5 percent for Americans, the study said.

Two or more risk factors at nonoptimal levels before such medical events were seen in more than 93 percent of individuals.

“These results not only challenge claims that CHD events frequently occur without antecedent major risk factors but also demonstrate that other CVD events, including HF or stroke, rarely occur in the absence of nonoptimal traditional risk factors, highlighting the importance of primordial prevention efforts,” the researchers wrote in the study.

CVD refers to cardiovascular disease.

In a Sept. 29 statement, Northwestern University, whose researchers led the study, stated that high blood pressure (hypertension) was the most common culprit in CVD events, occurring in more than 95 percent of Koreans and more than 93 percent of Americans.

“We think the study shows very convincingly that exposure to one or more nonoptimal risk factors before these cardiovascular outcomes is nearly 100 percent,” senior author Dr. Philip Greenland 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.”

The study was funded by the National Research Foundation of Korea, the National Center for Advancing Translational Sciences, and the National Heart, Lung, and Blood Institute. One of the researchers declared competing interests, having received grants from the National Research Foundation of Korea and the Korea Medical Institute.

US Cardiovascular Health

According to an October 2024 fact sheet published by the Centers for Disease Control and Prevention, heart disease is the leading cause of death among men and women in the United States. At least one individual dies from cardiovascular disease every 34 seconds, it stated.

“In 2023, 919,032 people died from cardiovascular disease. That’s the equivalent of 1 in every 3 deaths,” the agency stated.

In a Jan. 27 statement, the American Heart Association (AHA) said that many of the risk factors contributing to heart disease remain on the rise.

Almost 47 percent of American adults have high blood pressure, more than 72 percent have an unhealthy weight, and 57 percent have prediabetes or Type 2 diabetes, it stated.

“Although we have made a lot of progress against cardiovascular disease in the past few decades, there is a lot more work that remains to be done,” AHA volunteer Dr. Dhruv S. Kazi said.

“If recent trends continue, hypertension and obesity will each affect more than 180 million U.S. adults by 2050, whereas the prevalence of diabetes will climb to more than 80 million. And over the same time period, we expect to see a 300 percent increase in health care costs related to cardiovascular disease.”

A key contributor to cardiovascular disease is the consumption of sugar-sweetened beverages (SSBs), according to a Jan. 6 study in the Nature Medicine journal. These include soft drinks, lemonade, fruit juices, energy drinks, and homemade beverages.

“The results show that in 2020, 2.2 million cases of diabetes and 1.2 million cases of cardiovascular disease were attributable to the consumption of SSBs,” Lennert Veerman, a professor at Griffith University’s School of Medicine and Dentistry who took part in the research, said in a statement.

“Alarmingly, SSB consumption contributed to the deaths of 80,000 who had diabetes, and to the deaths of 250,000 people who had cardiovascular disease.”