New research underscores that the foundation for heart disease is often laid early in life, particularly for men. A study published in the Journal of the American College of Cardiology in November 2024 followed over 150,000 male military veterans for decades, starting from an average age of 42. It found that men who had at least two elevated risk factors—such as high blood pressure, high cholesterol, smoking, or diabetes—in young adulthood (ages 18-39) faced a dramatically higher risk of major cardiac events later in life.
The data showed these men were nearly 90% more likely to experience heart failure, stroke, or a heart attack after age 65 compared to those with optimal risk factor levels in youth. This association held true even for men whose risk factors improved in middle age, though risk was highest for those whose high-risk status persisted.
Cardiologists not involved with the study emphasize that these findings challenge the perception that heart health is only a concern for older adults. They stress that preventive measures, including diet, exercise, and regular screening for blood pressure and cholesterol, should begin much earlier. The American Heart Association recommends cardiovascular risk assessments starting at age 20.
While the study cohort was predominantly male and included many veterans, experts believe the implications for early prevention are broadly significant. The research adds to a growing body of evidence that managing health in one's 20s and 30s is critical for long-term cardiovascular outcomes.
