Last Updated: 2003-08-19 16:30:31 -0400 (Reuters Health)

CHICAGO (Reuters) - The vast majority of heart attacks affect people who smoke, have high blood pressure, high cholesterol or diabetes, debunking the perception that heart problems can strike anyone, researchers reported on Tuesday.

Roughly nine out of 10 heart patients surveyed had one of these four risk factors, often for years, before experiencing a heart problem, according to a pair of studies that analyzed accumulated data from previous trials.

The finding challenges claims repeated in medical literature that half of those who suffer heart-related events do not have any of the risk factors, reported study author Dr. Philip Greenland of Northwestern University in Chicago and associates.

Writing in the Journal of the American Medical Association, Greenland's group found risk factors were present in 92 percent of men who suffered heart attacks, and 87 percent of the women.

"Based on these and related findings concerning the major risk factors, we suggest that preventing development of unfavorable levels of blood cholesterol and blood pressure, cigarette smoking, diabetes, and unfavorable body weight (as a precursor of unfavorable blood lipid and blood pressure levels and diabetes) should be given even greater priority than is presently the case," they wrote.

Greenland's study analyzed data from three previous multiyear studies that surveyed nearly 400,000 subjects.

The second study, which analyzed surveys from outside the United States, found at least 85 percent of roughly 120,000 patients with angina or who underwent angioplasty or similar treatment had at least one of the four risk factors.

If the patient smoked, the heart event took place nearly a decade earlier than it did in patients who suffered from one of the other risk factors.

"It is increasingly clear that the four conventional risk factors and their resulting health risks are largely preventable by a healthy lifestyle," wrote study author Umesh Khot of Indiana Heart Physicians in Indianapolis and colleagues.

The studies provided "evidence that convincingly challenges the frequent claim that 'only 50 percent' of coronary heart disease is attributable to the conventional risk factors of smoking, diabetes, hypertension, and hyperlipidemia," note John Cano and Ami Iskandrian of the University of Alabama in an accompanying editorial.