Almost everyone has at least one heart disease risk factor before they get sick — like high blood pressure or cholesterol — no matter their age or gender. For women under 60, it's a bit less common, but still very high.

What we've found so far is that elevated cardiovascular risk factors are nearly universal before heart disease, stroke, or heart failure occur. Our analysis of the available evidence shows that most people have at least one known risk factor—like high blood pressure or high cholesterol—before developing a major cardiovascular event [1]. We looked at 49.0 studies or assertions that support this idea, and none that refute it [1]. This means the evidence we've reviewed strongly leans toward the conclusion that cardiovascular issues rarely appear without warning signs in advance. These risk factors are common across age groups and genders. Even in women under 60, where the presence of risk factors is slightly less frequent, they are still very common before illness develops [1]. We are analyzing this as part of our ongoing effort to understand what the research shows about heart health. This does not mean that having a risk factor always leads to disease, or that people without known risk factors are completely safe. But what we can say, based on what we've reviewed so far, is that most individuals show measurable warning signs before a cardiovascular event occurs. We don’t yet know how early these signs appear or how strongly each one contributes to actual illness. Also, our current analysis doesn’t tell us whether catching and treating these risk factors early always improves outcomes—though that’s an important question we’re continuing to explore. Practical takeaway: Most people show signs like high blood pressure or high cholesterol before heart problems happen—so regular check-ups could help spot risks early.