Men may develop coronary heart disease earlier than women, with differences starting as early as their mid-30s, according to a study led by Northwestern Medicine. The research tracked more than 5,100 Black and white adults over three decades as part of the Coronary Artery Risk Development in Young Adults (CARDIA) study.
The analysis showed that men reached a 5% incidence of cardiovascular disease—including heart attack, stroke, and heart failure—at about age 50.5, while women reached the same level at around 57.5 years old. This difference was mainly due to coronary heart disease; men hit a 2% incidence rate more than ten years before women did. Rates of stroke were similar between 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," said Freedman.
Researchers examined if factors such as blood pressure, cholesterol, blood sugar, smoking habits, diet, physical activity, and body weight could explain why men developed heart disease earlier. While hypertension explained some of the gap, overall cardiovascular health measures did not fully account for the difference. The authors suggest other biological or social factors might play a role.
One notable finding was that men's risk began rising faster than women's around age 35 and remained higher through midlife. "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.
Despite efforts to reduce risk factors like smoking and high blood pressure among both sexes over recent decades, the gap has not narrowed significantly. The study also notes that preventive care rates are uneven among U.S. adults aged 18 to 44; women are more likely than men to attend routine checkups due largely to gynecologic visits.
The authors point out new American Heart Association PREVENT risk equations can predict heart disease starting at age 30 as a potential tool for earlier intervention.
Freedman emphasized: "Cardiovascular disease remains the leading cause of death for both men and women, and prevention is critical for everyone."
