Nonoptimal Levels of Traditional Risk Factors Almost Universal Before CVD
MONDAY, Sept. 29, 2025 -- Almost all adults have nonoptimal levels of one or more traditional risk factors before being diagnosed with cardiovascular disease (CVD), according to a study published online Sept. 29 in the Journal of the American College of Cardiology.
Hokyou Lee, M.D., Ph.D., from the Yonsei University College of Medicine in Seoul, South Korea, and colleagues analyzed two population-based prospective cohorts: the Korean National Health Insurance Service (KNHIS; 9,341,100 participants) and the Multi-Ethnic Study of Atherosclerosis (MESA; 6,803 participants). The antecedent occurrence of nonoptimal levels of four traditional risk factors (blood pressure, cholesterol, glucose, and tobacco smoking) was examined before first coronary heart disease (CHD), heart failure, or stroke.
The analyses included 601,025 and 1,188 CVD events in KNHIS and MESA, respectively. The researchers found that in KNHIS and MESA, the prevalence of one or more nonoptimal risk factor was high before CHD (99.7 and 99.6 percent, respectively), with similar patterns seen before heart failure (99.4 and 99.5 percent, respectively) and stroke (99.3 and 99.5 percent, respectively). Across age groups, the prevalence of one or more risk factor before CVD was consistently high (>99 percent) in both men and women; the lowest proportion was seen for heart failure and stroke (>95 percent) when occurring before age 60 years in women. Before CVD events, the prevalence of two or more risk factors was also common (93.2 and 97.2 percent, respectively).
"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," senior author Philip Greenland, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, said in a statement.
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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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