More people having their first major heart attack don’t have the usual risk factors like high blood pressure or smoking — and that number went up from about 1 in 7 to 1 in 4 over 18 years.

What we've found so far suggests that the number of first-time heart attack patients without traditional risk factors may have increased over time. Our analysis of the available evidence shows a trend in which more people are experiencing their first major heart attack despite not having common risk factors like high blood pressure or smoking. The evidence we’ve reviewed indicates that over an 18-year period, the proportion of these patients rose from about 1 in 7 to 1 in 4 [1]. This means that, based on what we've seen so far, a growing share of individuals facing their first heart attack do not fit the typical risk profile. The data supporting this comes from 53.0 studies or assertions that align with this trend, and we found no studies that contradict it [1]. We want to be clear: this does not mean traditional risk factors are no longer important. It also does not mean we fully understand why this shift might be happening. Our current analysis only shows a pattern in the data — one that suggests heart attacks are affecting a broader group of people than before, including those who might be considered low-risk by conventional standards. Since we’re working with limited assertions — just one distinct claim so far — our understanding is still early and could change as more evidence is reviewed. We don’t yet know what factors might be driving this trend, or whether detection methods, lifestyle changes, or other unknown variables are involved. Practical takeaway: Even if you don’t have high blood pressure, high cholesterol, or other classic risks, maintaining heart-healthy habits — like eating well, staying active, and getting regular check-ups — could still be important. Heart health may involve more than we currently measure.