Research indicates that young men should not overlook heart health, as the risk of cardiovascular disease (CVD) may increase earlier than previously thought. A long-term study led by researchers at Northwestern Medicine suggests that men begin developing CVD years before women. The findings, published in the Journal of the American Heart Association, reveal significant differences in cardiac risk starting in men’s mid-30s.
The study utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which began in 1985. The cohort included 5,115 Black and White men and women aged 18 to 30 from four U.S. cities. None had cardiovascular disease at the outset, and they attended follow-up visits every two to five years for the next three decades. During these visits, researchers monitored blood pressure, cholesterol, and other markers of heart health.
Lead author Alexa Freedman, an epidemiologist and assistant professor at Northwestern University Feinberg School of Medicine, noted that the findings show the risk of CVD in men emerges significantly earlier than in women. “Our findings show that differences in cardiovascular disease risk between men and women emerge by age 35,” Freedman stated. This suggests that young adulthood is a critical period for implementing heart health prevention strategies.
The study identified coronary heart disease (CHD) as a major factor contributing to the earlier risk for men. Starting at age 35, men were nearly twice as likely as women to develop CVD within the following decade. By the age of 50, approximately 4.7 percent of men had developed CVD, compared to 2.9 percent of women, who did not reach similar risk levels until age 57. In terms of CHD specifically, 2.5 percent of men had developed it by age 50, whereas only 0.9 percent of women had experienced the same by that age.
While stroke risk appeared to be similar for both genders by age 50, with about 1.2 percent affected in each group, differences in heart failure risk were smaller and emerged later in life. Notably, even as men continued to exhibit a higher likelihood of heart-related events, women’s risk approaches men’s as they age.
The study also examined various risk factors, including smoking, high blood pressure, and Type 2 diabetes, which contribute to higher CVD risk. Interestingly, the gender gap in risk persisted even after accounting for these factors, indicating that traditional risk profiles may not fully capture the nuances of heart health in younger adults.
Srihari S. Naidu, a cardiologist and professor at New York Medical College, emphasized the significance of understanding how early the elevated risk begins. As some participants were still young at the end of the follow-up period, the study could not fully assess how sex differences in heart disease risk evolve later in life, particularly for women post-menopause when their risk tends to increase rapidly.
Typically, CVD screening focuses on adults over 40, but Freedman advocates for assessing risk in younger adults as well. Laxmi Mehta, a non-invasive cardiologist at The Ohio State University Wexner Medical Center, echoed this sentiment, asserting that age should not be seen as a protective factor. “Clinicians should not miss the critical window of risk prevention in younger patients, regardless of sex,” she stated.
Many physicians still rely on traditional risk calculators designed for older adults, which often overlook non-traditional risk factors such as autoimmune conditions, adverse pregnancy outcomes, and elevated lipoprotein(a) levels. These factors can provide a more comprehensive view of heart attack risk, even in otherwise healthy young individuals. For instance, complications from pregnancy, including preeclampsia and gestational diabetes, have been linked to a higher risk of developing heart disease later.
In light of these findings, the emphasis on early and proactive approaches to heart health is paramount. “The time to take action to prevent cardiovascular disease and heart attack—no matter your sex—is now,” Mehta advised. She recommends that individuals start considering heart disease risk reduction as part of their daily routine, beginning in childhood.
The American Heart Association’s guidelines, known as Life’s Essential 8, serve as a benchmark for maintaining heart health. These guidelines include crucial lifestyle choices such as regular exercise, a balanced diet, and effective stress management. Furthermore, the relationship between mental health and cardiovascular health is significant; conditions like social isolation and depression can hinder adherence to lifestyle changes and treatments.
Even if individuals check all the boxes of healthy living, Naidu cautions against complacency. “Go to the doctor routinely, starting perhaps at age 30, to review your family history and other risk factors,” he advised. Ultimately, identifying and managing risk factors is crucial for everyone, and early intervention can lead to a healthier future.
