Almost everyone who suffers a heart attack, stroke or heart failure experiences warning signs years before the event, according to landmark research. However, high blood pressure – also known as hypertension – was by far the most common culprit, affecting more than nine in ten of participants. They were able to follow participants for up to two decades, thanks to routine health screenings that recorded blood pressure, cholesterol, glucose and smoking history. Alongside high blood pressure, factors included raised blood sugar or a diabetes diagnosis, high cholesterol and past tobacco use. Raised blood pressure, cholesterol and blood sugar can often be controlled through lifestyle changes such as diet, exercise and stopping smoking, as well as with medication.