Heart disease is often thought of as a problem that appears later in life, usually after decades of unhealthy habits.
However, a large study that followed people from young adulthood into middle age suggests that the danger may begin much earlier than many realize.
The research found that men start showing a higher risk of heart disease years before women, and this gap opens up surprisingly early in adulthood.
The study tracked participants for more than 30 years and revealed that men reached a 5 percent risk of developing cardiovascular disease about seven years earlier than women. Cardiovascular disease includes conditions such as heart attack, stroke, and heart failure.
The earlier rise in risk among men was mainly driven by coronary heart disease, which is the narrowing or blockage of the arteries that supply blood to the heart and is the leading cause of heart attacks.
What makes the findings especially striking is how early the difference begins. The researchers found that men and women had very similar heart disease risk through their 20s and early 30s.
Around age 35, however, men’s risk began to climb more rapidly and stayed higher through midlife. This suggests that important changes affecting heart health may be happening well before most people consider themselves at risk.
The research was led by scientists at Northwestern Medicine and published in the Journal of the American Heart Association. The team used data from the Coronary Artery Risk Development in Young Adults study, often called CARDIA.
This long-running project began in the mid-1980s and enrolled more than 5,100 Black and white adults between the ages of 18 and 30. All participants were generally healthy when they joined the study, which allowed researchers to clearly observe when heart disease risk first began to emerge.
Over time, the researchers tracked new diagnoses of cardiovascular disease and compared how risk developed in men and women. By the end of the follow-up period in 2020, all participants were still under the age of 65. Men reached a 5 percent rate of cardiovascular disease at an average age of about 50, while women reached the same level closer to age 57.
When the researchers looked more closely, they found that coronary heart disease accounted for most of this difference. Men reached a 2 percent rate of coronary heart disease more than 10 years earlier than women.
Other types of heart-related problems showed different patterns. Stroke rates were similar in men and women, and differences in heart failure appeared later in life. This fits with what doctors already know, since stroke and heart failure often develop at older ages compared to coronary heart disease.
The researchers also examined whether traditional risk factors could explain why men developed heart disease earlier. These included high blood pressure, cholesterol levels, blood sugar, smoking, diet, physical activity, and body weight.
While high blood pressure and some other factors explained part of the difference, they did not fully account for the earlier rise in risk among men. Even when these factors were considered together, men still showed higher risk at younger ages.
This finding surprised the researchers. Over the past several decades, many risk factors such as smoking and diabetes have become more similar between men and women. Because of this, scientists expected the gap in heart disease timing to shrink. Instead, it remained.
This suggests that other influences, possibly related to biology, hormones, stress, work patterns, or social behavior, may be playing an important role.
Another important insight from the study is the role of preventive care. In the United States, young women are far more likely than young men to attend routine medical checkups, often because of reproductive health visits.
Men between the ages of 18 and 44 are much less likely to see a doctor regularly. This means early warning signs of heart disease may go unnoticed in men during a critical period when prevention could be most effective.
The researchers suggest that heart disease screening and prevention may need to start earlier, particularly for men. New risk prediction tools, such as those developed by the American Heart Association, can estimate heart disease risk starting at age 30.
Using these tools could help doctors identify people at risk sooner and recommend lifestyle changes before serious damage occurs.
When reviewing and analyzing the study’s findings, the key message is that heart disease does not suddenly appear in old age. It develops slowly over decades, with early changes beginning in young adulthood. The fact that men’s risk starts rising in the mid-30s highlights a missed opportunity for early action.
While traditional risk factors remain important, they do not tell the whole story. Addressing broader biological and social influences, along with improving access to preventive care for young men, may be essential to closing the gap.
Overall, the study underscores the importance of early awareness and prevention. Heart disease remains the leading cause of death for both men and women. Recognizing that risk can begin much earlier than expected may help more people protect their heart health long before symptoms appear.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.
For more health information, please see recent studies about how drinking milk affects risks of heart disease and cancer, and results showing strawberries could help prevent Alzheimer’s disease.
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