A groundbreaking international study has revealed that more than 99% of heart disease cases could have been prevented by managing common risk factors earlier in life. The research highlights that most heart attacks, strokes, and other cardiovascular diseases are not sudden events without warning but are strongly linked to identifiable, treatable health conditions.
The New Study and Its Findings
The study, published in the Journal of the American College of Cardiology (September 2025), analysed:
Health data from over 600,000 cardiovascular disease patients in South Korea
Additional data from around 1,000 patients in the United States
Researchers closely examined whether traditional cardiovascular risk factors were present in these patients before their diagnosis. These factors included:
High blood pressure
High blood sugar
High cholesterol levels
Smoking history
The results were striking. In more than 99% of cases, patients had at least one of these risk factors before suffering a heart attack, stroke, or heart failure.
Dr Philip Greenland, a professor of preventive medicine at Northwestern University, explained that even mild elevations in these risk factors should not be ignored. He noted that early intervention with lifestyle changes or medication can significantly reduce the likelihood of developing heart disease.
Expert Reactions on the Study
Several international experts have emphasised the importance of the study’s findings:
Dr Susan Cheng (Smidt Heart Institute, Cedars-Sinai, Los Angeles) praised the study for going beyond simple diagnoses. Instead of only recording labels like “diabetes” or “hypertension,” the researchers examined raw medical data, which revealed that most patients already had measurable risk markers before cardiovascular disease developed.
Dr Karen Joynt Maddox (Washington University, St Louis) highlighted the challenge of prevention. While heart disease risk factors are well-known, motivating patients to act before illness strikes is still very difficult. She pointed out that people often ignore risks unless symptoms or disease are already present.
Dr Ahmed Tawakol (Massachusetts General Hospital, Harvard) stressed the importance of viewing prevention not as “fighting ageing” but as “extending longevity.” He urged people to see managing blood pressure, sugar, and cholesterol as positive steps to stay healthier for longer, not as a burden of ageing.
Lifestyle Changes Still Key
Beyond medical treatments, lifestyle improvements remain central to heart health. Experts underline that sustainable daily habits are as crucial as clinical management. Key recommendations include:
Regular exercise, such as walking, swimming, or cycling
Maintaining a balanced diet rich in fruits, vegetables, and whole grains
Achieving and maintaining a healthy weight
Prioritising quality sleep and reducing stress levels
Avoiding or quitting smoking
Dr Tawakol also noted that stress and depression are as harmful to the heart as smoking or diabetes, reinforcing the importance of looking after both physical and mental health.
Why Prevention Remains a Struggle
Even with decades of medical progress, preventing heart disease continues to be challenging. Part of the difficulty lies in the “invisible” nature of risk factors:
Conditions like high blood pressure or cholesterol often show no clear symptoms early on.
Patients may feel healthy and underestimate the long-term toll these risk factors can take.
Starting medications or lifestyle changes is sometimes resisted, as patients associate them with ageing instead of longevity.
The Path Forward
The study’s message is clear: nearly every case of heart disease can be linked to modifiable factors. This means doctors and patients have powerful tools to reduce risk, if action is taken early.
By focusing on controlling blood pressure, blood sugar, cholesterol, and quitting smoking, people can drastically lower their likelihood of suffering a major cardiovascular event. Combining medical monitoring with healthier lifestyles — better nutrition, physical activity, stress management, and mental health support — may be the most effective way to ensure longer, healthier lives.
Sources
Journal of the American College of Cardiology — Study link
CNN Health Reports on Wellness Studies: Article 1, Article 2, Article 3
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