Absence of five major cardiovascular risk factors (hypertension, hyperlipidemia, abnormal weight (underweight or overweight/obesity), diabetes, and smoking) at 50 years of age can extend life expectancy by more than a decade in both men and women. Controlling high blood pressure and quitting smoking in middle age also made a significant impact. These findings from a study by the Global Cardiovascular Risk Consortium involving over 2 million participants was published March 30, 2025 in the New England Journal of Medicine.¹

This global study, involving 2,078,948 participants from 133 cohorts in 39 countries, examined how the presence of five traditional cardiovascular (CV) risk factors affects the lifetime risk of cardiovascular disease (CVD) and all-cause mortality. The analysis enrolled individuals at age 50, and assessed their estimated life expectancy and years lived free of CVD or death up to 90 years of age based on the presence or absence of these five risk factors.

Results showed that men with all five risk factors at age 50 had a 38% lifetime risk of CVD, while this risk was 24% in women with all five risk factors. When participants with none of the risk factors and those with all the risk factors were compared, it was found that women gained 13.3 additional years free of CVD and 14.5 years free of death. Men gained 10.6 years free of CVD and 11.8 years free of death. Control of high blood pressure between ages 55 and 60 was associated with the most additional CVD-free years. Smoking cessation in the same age range contributed the most additional years free of death.

This study illustrates the high burden of traditional cardiovascular risk factors in middle-aged individuals and reemphasizes the impact of primary prevention. Equally important, it bolsters the benefits of secondary prevention even when started at midlife. Cardiovascular risk assessment at age 50 therefore is important to mitigate risk factors, if present, and improve health outcomes with tailored interventions. It is never too late to act.

Reference

1.   Global Cardiovascular Risk Consortium; Christina Magnussen, et al. Global effect of cardiovascular risk factors on lifetime estimates. N Engl J Med. 2025 Mar 30. doi: 10.1056/NEJMoa2415879.