Men's Heart Health Risk Emerges in Mid-30s, Underscoring Need for Earlier Prevention

A landmark study spanning over three decades has revealed a concerning trend: men's risk of developing coronary heart disease, a precursor to heart attacks, escalates in their mid-30s, years before women experience a similar surge. This finding, published in the Journal of The American Heart Association and led by Northwestern Medicine researchers, suggests that current cardiovascular screening and prevention paradigms may be overlooking a crucial window for intervention.The research, which analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study involving over 5,100 Black and white participants initially aged 18-30 in the mid-1980s, tracked individuals through 2020. It pinpointed that while men and women exhibit similar cardiovascular risk profiles in their early thirties, a divergence begins around age 35, with men's risk climbing at a faster rate and remaining elevated through midlife.Men reached a 5% incidence of cardiovascular disease (encompassing heart attack, stroke, and heart failure) approximately seven years earlier than women, with coronary heart disease being the primary driver of this disparity. Specifically, men reached a 2% incidence of coronary heart disease more than a decade sooner than their female counterparts. This early onset is particularly significant given that cardiovascular disease develops over many years, with initial markers often detectable in young adulthood.While traditional risk factors such as smoking, hypertension, diabetes, cholesterol, and blood pressure were examined, researchers found that these factors alone did not fully account for the observed sex-based gap in heart disease development. This suggests that a broader range of biological and social factors may be at play, necessitating a more holistic approach to understanding and mitigating cardiovascular risk.The study's senior author, Alexa Freedman, an assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine, emphasized the importance of this discovery. "Screening at an earlier age can help identify risk factors sooner, enabling preventive strategies that reduce long-term risk," Freedman stated. She noted that while older studies have consistently shown men experiencing heart disease earlier, the persistence of this gap, even as traditional risk factors have become more similar between sexes, was surprising.Current guidelines often recommend heart disease screening for adults over 40. However, the new findings advocate for an earlier start, aligning with tools like the American Heart Association's PREVENT risk equations, which can assess risk from age 30. The study also highlighted a significant disparity in preventive care uptake, with women aged 18-44 being over four times more likely than men to attend routine checkups. This difference is partly attributed to gynecologic and obstetric visits, underscoring a missed opportunity for men to engage in preventative healthcare."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 added. Cardiovascular disease remains the leading cause of death for both sexes globally, reinforcing the critical need for robust, universally accessible, and age-appropriate prevention strategies across all demographics.