New Delhi, Sep 30: Heart attack, stroke, or heart failure come with warning signs in 99 per cent cases, according to a large study that refuted the notion that these devastating events often strike people without warning signs.

The study led by Northwestern Medicine, US, and Yonsei University in South Korea, showed people with these deadly cardiovascular diseases -- which remain the leading cause of death worldwide -- had at least one risk factor above an optimal level beforehand.

"We think the study shows very convincingly that exposure to one or more nonoptimal risk factors before these cardiovascular outcomes is nearly 100 per cent," said senior author Dr. Philip Greenland, professor of cardiology at Northwestern University Feinberg School of Medicine.

"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," Greenland added.

The team selected four major cardiovascular risk factors: blood pressure, cholesterol, blood sugar, and tobacco use.

The scientists analysed health data from more than 9.3 million Korean adults and nearly 7,000 US adults, who were followed for up to two decades.

The findings, published in the Journal of the American College of Cardiology, showed that more than 99 per cent of people who developed coronary heart disease, heart failure, or stroke had at least one nonoptimal risk factor before their event. Over 93 per cent had two or more risk factors.

High blood pressure, or hypertension, was the most common culprit, affecting over 95 per cent of patients in South Korea and more than 93 per cent in the US.

Even in women under 60 -- the group often assumed to be at lowest risk -- more than 95 per cent still had at least one nonoptimal factor before heart failure or stroke.

In a secondary analysis, the team also looked at clinically elevated risk factors, the higher thresholds doctors often use for diagnosis: blood pressure more than 140/90, cholesterol more than 240, glucose more than 126, and current smoking.

In such scenarios, at least 90 per cent of patients still had at least one major risk factor before their first cardiac event.

(IANS)

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