Study Reveals Earlier Heart Disease Risk in Men

A recent long-term study indicates that men face a heightened risk of cardiovascular disease much earlier than women, starting from around age 35.

This report, released on Wednesday in the Journal of the American Heart Association, monitored over 5,000 adults throughout their young adult years. The findings show that men reach clinically significant cardiovascular levels approximately seven years before women do.

Experts recommend that both men and women should keep a close eye on their heart health during early adulthood and make regular visits to their doctors.

“Heart disease doesn’t happen overnight; it develops over years. One aspect that I think many might not realize is that it can start as early as your 30s or 40s,” said Dr. Sadiya Khan, a professor in cardiovascular epidemiology at Northwestern University Feinberg School of Medicine in Chicago.

Dr. Khan added, “Even if you don’t show signs of heart disease initially, your risk can still begin at that time.”

Historically, a “10-year gap” in heart disease between men and women is largely attributed to coronary heart disease, which involves the narrowing of the heart’s arteries due to plaque buildup, more commonly seen in men.

“The ‘10-year gap’ is a widely referenced statistic indicating that men tend to develop heart disease about a decade earlier than women. Previous research mainly focused on coronary heart disease,” mentioned Alexa Freedman, the study’s senior author and an assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine.

Freedman pointed out that the landscape of cardiovascular disease risk factors has shifted over the years. “For example, smoking rates have decreased for men and are now similar to those of women. Hypertension rates have also become more comparable,” she noted.

The research aimed to determine if this gender gap exists across other forms of cardiovascular disease, like heart failure and stroke. The analysis looked into premature cardiovascular disease, defined as that which occurs before age 65, considering both general cardiovascular issues and specific types, including coronary heart disease, stroke, and heart failure.

The study analyzed data from 5,112 Black and White adults across four states in the U.S., all of whom participated in the Coronary Artery Risk Development in Young Adults study beginning in 1985, when they were between 18 and 30 years old.

All participants were healthy when they enrolled, and they have been followed for a median of 34.1 years, with regular examinations. Throughout this period, 160 women and 227 men experienced cardiovascular disease events.

Freedman emphasized that participants joined the study before most risk factors typically surface, allowing researchers to track the onset of disease more accurately than in studies where patients are recruited later in life.

One striking finding involved analyzing rolling 10-year risk windows. Instead of looking at a single lifetime risk, researchers calculated the likelihood of developing heart disease over the next decade at various ages.

It turned out that until their early 30s, both men and women had comparable short-term cardiovascular risk. However, around age 35, their risks began to separate, with men consistently facing a higher 10-year risk. By age 50, for example, the risk was about 6% for men compared to roughly 3% for women.

During the follow-up, men were found to develop cardiovascular disease earlier. By age 50, about 5% of men had developed the disease, nearly seven years sooner than women, who typically reached that level around age 57.

The risk disparity was even more pronounced when examining coronary heart disease specifically. “In our study, approximately 2% of men had developed coronary heart disease by age 48, while women didn’t reach that incidence until closer to 58, highlighting that 10-year gap,” Freedman explained.

Interestingly, this difference cannot solely be attributed to traditional risk factors like blood pressure or cholesterol levels. However, Dr. Iris Jaffe, the executive director of the Molecular Cardiology Research Institute at Tufts Medical Center, noted that other social factors, which were challenging to quantify, might also play a role.

“Women often face different kinds of stress and work dynamics than men. Those factors weren’t accounted for in the research,” she stated.

Dr. Jaffe emphasized the importance of further investigating biological differences. “There are certainly biological discrepancies between men and women influencing these outcomes, and we’re just starting to understand them,” she added.

Overall, the researchers found no significant differences in stroke risk between the sexes; both reached similar stroke incidence rates at almost the same ages. While heart failure also showed little early difference, men had a slightly higher incidence by age 65.

Regardless of these findings, Dr. Jaffe cautioned that women should still remain vigilant about their heart health. “I worry that discoveries like this might lead women to feel less concerned about heart disease. It’s still a leading cause of death for women,” she mentioned. “It’s vital for everyone to focus on health during young adulthood to help prevent heart disease.”

This concern is particularly relevant as women’s risk for heart disease can increase significantly post-menopause, as Khan elaborated. “The hypothesis suggests that estrogen can be protective, so women may experience heart disease risks roughly a decade later, but then, after menopause, this risk accelerates,” she said.

The average age of menopause in the U.S. is about 52.

This study coincides with evolving cardiovascular guidelines that increasingly advocate for risk assessments to begin earlier. The updated American Heart Association risk equations now allow for estimating cardiovascular risk starting at age 30, rather than the previous age of 40—a change Freedman believes is supported by their findings.

The results also touch on broader issues surrounding healthcare access. Young women tend to have significantly more preventive care visits compared to men, mainly due to reproductive health needs, which can lead to earlier risk detection and counseling, as the study authors noted.

“Young men are generally less likely to seek routine care during their 30s and 40s, so increasing preventive care visits among young men could be an effective strategy for promoting heart health and reducing cardiovascular risk,” Freedman suggested.

Dr. Jaffe encouraged young adults to see their doctors annually for health check-ups, including measuring blood pressure and cholesterol levels. For those needing additional guidance, she advised following the American Heart Association’s “Life’s Essential 8,” which encompasses actions to maintain cardiovascular health.

“These actions emphasize managing traditional risk factors like avoiding tobacco, maintaining a healthy weight, and controlling blood pressure, blood sugar, and cholesterol. Additionally, incorporating healthier eating, increasing physical activity, and getting sufficient sleep are crucial,” Dr. Jaffe remarked.

Dr. Khan reiterated that tracking cholesterol, blood pressure, and blood sugar levels is essential. “You need to understand your risk factors, so you know where you stand and can take proactive measures,” she concluded.