Overview

• An international analysis in the Journal of the American College of Cardiology found that more than 99% of first heart attacks, strokes or heart-failure cases occurred in people with at least one preexisting risk factor above optimal levels.
• Researchers reviewed records for over 9.3 million adults in South Korea and nearly 7,000 in the United States, with follow-up exceeding a decade in many cases.
• Four modifiable risks predominated—hypertension, elevated cholesterol, high glucose or diabetes, and smoking—with high blood pressure present in over 95% of cases in Korea and over 93% in the U.S.
• Even under stricter clinical cutoffs, at least 90% had a major risk factor before their first event, and more than 95% of women under 60 had at least one non‑optimal factor.
• WHO estimates cardiovascular disease causes about 17.9 million deaths annually, while the AHA says up to 80% of premature events are preventable through exercise, healthy diet, adequate sleep, weight control, avoiding tobacco and managing stress; some media also report a 4‑7‑8 breathing routine as a stress‑reduction aid attributed by a physician to Harvard researchers.