Nearly All Heart Attacks Are Preventable: New Cardiology Evidence on Cardiovascular Risk
A landmark study recently published in the Journal of the American College of Cardiology (JACC) confirms something that seasoned clinicians have long suspected but patients rarely hear: more than 99% of people who go on to have a heart attack, stroke, or heart failure event had at least one modifiable cardiovascular risk factor that was not optimally controlled before their event.
Breaking Down the New Evidence
Researchers analyzed health records from two large cohorts, one in South Korea and one in the United States, that included millions of adults. Their analysis looked at four traditional cardiovascular risk factors:
Elevated blood pressure
Elevated cholesterol
Elevated fasting glucose (or diabetes)
Current or past smoking
They found that nearly everyone who developed coronary heart disease, heart failure, stroke, or similar cardiovascular events had at least one of these risk factors at non-optimal levels before the event occurred.
What “Non-Optimal” Risk Factor Levels Means
In this study, traditional risk factor thresholds were defined as:
Systolic blood pressure ≥ 120 mm Hg or diastolic blood pressure ≥ 80 mm Hg
Total cholesterol ≥ 200 mg/dL (*Note omission of LDL and ApoB)
Fasting glucose ≥ 100 mg/dL or diagnosis of diabetes
Cigarette tobacco use
Even when some patients were receiving treatment, if these markers weren’t optimally controlled, the risk remained elevated.
Why This Matters to You
At Paradigm Direct Health, we often say that cardiovascular events don’t happen in a vacuum; they are the result of a long, silent buildup of risk. This study reinforces that concept on a massive scale. More importantly, it underscores two practical realities:
Most cardiovascular risk is detectable well before an event occurs.
Most risk is modifiable with proactive medical care and lifestyle support.
That means effective prevention isn’t luck — it’s planning and partnership.
What Patients Should Take From This
1. Comprehensive Risk Assessment Is Essential
Traditional risk calculators are a starting point, but sophisticated evaluation including assessments of blood pressure trends, cholesterol particle profiles, glucose metabolism, and lifestyle exposures gives a far richer picture of cardiovascular risk. I would argue a Coronary Artery Scan gives us even more information about your short term risk.
2. Risk Factor Control Is Not Just About Medication
Achieving optimal control often requires a combination of:
Targeted lifestyle change (diet, physical activity, sleep, stress management)
Precision pharmacotherapy where indicated
Regular monitoring and early intervention
Behavioral support and accountability
In other words, prevention is not passive - it’s a strategic process.
3. Personalized Care Adds Power
Unlike standard fee-for-service systems where risk factors may be addressed piecemeal, concierge-aligned care allows us to:
Spend time understanding your unique risk profile
Use advanced labs and imaging strategically
Adjust interventions dynamically over time
Coordinate multidisciplinary support when needed
Real-World Application: What We Do Differently
At Paradigm Direct Health, we treat cardiovascular risk the way top cardiovascular prevention clinics do - aggressively, holistically, and early. This includes:
Regularly scheduled comprehensive cardiovascular risk assessments
Lifestyle medicine support integrated with clinical treatment
Advanced lipid and inflammatory risk testing where clinically appropriate
Continuous care coordination and follow-up
Bottom Line
If you have risk factors, even ones you’ve been told are “borderline”, this new evidence tells us something powerful: those risk factors matter, and they predict real outcomes. But the good news is equally powerful: risk factor modification works, and it almost always makes a difference.
If you’re ready to take a proactive, personalized approach to cardiovascular health — one that strives to reduce your risk before a cardiac event happens — contact us at Paradigm Direct Health. Together, we can craft a plan as unique as you are.