Men reach critical heart disease risk level years before women – Study

By Sola Ogundipe

Heart disease risk begins to climb for men in their mid-30s, years before it rises for women, a decades-long study tracking people from young adulthood has uncovered.

From the study titled “Sex Differences in Age of Onset of Premature Cardiovascular Disease and Subtypes: The Coronary Artery Risk Development in Young Adults Study,” men reached a 5 percent risk of cardiovascular disease roughly seven years earlier than women, revealing a clear and early gap in heart health.

The study was published in the Journal of The American Heart Association. The research team analysed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The project enrolled more than 5,100 Black and white adults between ages 18 and 30 in the mid-1980s and followed them through 2020.

Because participants were healthy at the start, the researchers were able to identify when cardiovascular disease risk first began to separate between men and women. Men reached a 5 percent rate of cardiovascular disease, defined broadly to include heart attack, stroke and heart failure, about seven years earlier than women (50.5 versus 57.5 years).

Coronary heart disease accounted for most of this difference, driving the earlier rise in risk among men. Heart disease risk looked similar for men and women until about age 35, when men’s risk began to increase more quickly.

According to the long-term study led by Northwestern Medicine, based on more than 30 years of follow-up, the findings suggest that heart disease screening and prevention may need to begin earlier in adulthood, especially for men.

“That timing may seem early, but heart disease develops over decades, with early markers detectable in young adulthood,” said study senior author Alexa Freedman, assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine.

“Screening at an earlier age can help identify risk factors sooner, enabling preventive strategies that reduce long-term risk.”

Previous research has long shown that men tend to develop heart disease earlier than women. Over time, however, common risk factors such as smoking, high blood pressure and diabetes have become more alike between the sexes. Because of this, researchers expected the difference in heart disease timing to shrink. Instead, the gap remained. That result was unexpected, Freedman said.

To better explain why these differences continue, Freedman and her colleagues say researchers need to look beyond standard measures like cholesterol and blood pressure and consider a wider range of biological and social influences.

Most of this difference was due to coronary heart disease. Men reached a 2 percent incidence of coronary heart disease more than 10 years earlier than women. Stroke rates were similar for both sexes, and differences in heart failure appeared later in life.

“This was still a relatively young sample — everyone was under 65 at last follow-up — and stroke and heart failure tend to develop later in life,” Freedman explained.

One of the most notable findings was when the risk gap began. Men and women had similar cardiovascular risk through their early 30s. Around age 35, men’s risk increased more quickly and remained higher through midlife.

Many heart disease prevention and screening efforts focus on adults older than 40.

The new results suggest this approach may miss an important early window for action.

“Our findings suggest that encouraging preventive care visits among young men could be an important opportunity to improve heart health and lower cardiovascular disease risk,” Freedman said.

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