- A long-term study found men’s heart disease risk begins diverging from women’s at age 35.
- Men reached major heart disease milestones seven to 10 years earlier than women.
- Lifestyle factors didn’t fully explain why men developed heart disease earlier.
You probably didn’t expect your 35th birthday to come with a recommendation to see a cardiologist. After all, heart disease feels like something that happens to folks in their 50s or 60s, not people in their mid-30s. But new research suggests that for men, this milestone birthday might be exactly when it’s time to start paying closer attention to cardiovascular health, even if you feel perfectly fine.
A new study published in the Journal of the American Heart Association followed thousands of young adults over more than three decades to pinpoint exactly when heart disease risk starts to diverge between men and women. The findings are striking: That divergence begins around age 35—not in later middle age as many might assume—and persists even among people with healthy lifestyles. For men, particularly those with a family history of heart disease, this research suggests the mid-30s may be an ideal time to start conversations with a preventive cardiologist.
Let’s break down what the researchers found and what it means for you.
How Was This Study Conducted?
Researchers used data from the CARDIA (Coronary Artery Risk Development in Young Adults) study, a long-term research project that began in 1985. At the start of the study, more than 5,100 Black and white adults between the ages of 18 and 30 were enrolled across four U.S. cities: Birmingham, Chicago, Minneapolis and Oakland. The participants were followed for a median of 34 years, with regular check-ins that tracked their cardiovascular health, lifestyle habits and any heart-related events.
This long follow-up period allowed researchers to pinpoint exactly when heart disease risk begins to diverge between men and women—and whether factors like diet, exercise and blood pressure could explain those differences. The study focused on “premature” cardiovascular disease, defined as events occurring before age 65, including heart attacks, strokes and heart failure.
What Did the Study Find?
The results confirmed what earlier research had suggested and added important new details. By age 50, about 5% of men in the study had developed cardiovascular disease—a threshold women didn’t reach until age 57, a full seven years later. When researchers looked specifically at coronary heart disease (which includes heart attacks), the gap was even larger: Men reached a 2% mark a full 10 years earlier than women.
Crucially, the researchers found that sex differences in 10-year cardiovascular disease event rates first became statistically significant at age 35. In other words, by the time men hit their mid-30s, their risk of developing heart disease over the next decade starts to outpace that of women—and this gap persists through midlife.
Interestingly, the study found no significant difference between men and women when it came to stroke risk. The differences were most pronounced for coronary heart disease, with smaller but still notable gaps for heart failure that emerged at later ages.
Perhaps most surprising was this finding: Even after accounting for differences in cardiovascular health measures—like blood pressure, cholesterol, blood sugar, body mass index, diet quality, physical activity and smoking status—men still had a significantly higher risk of cardiovascular disease than women. This suggests that traditional risk factors don’t fully explain why men develop heart disease earlier.
The researchers noted a few caveats. Because participants were still relatively young by the end of the study, the absolute number of some cardiovascular events (like strokes) was low. The study also included only Black and white participants, so the results may not apply to other groups. Additionally, sleep—now considered an important factor in heart health—wasn’t measured at the start of the study and couldn’t be fully included in the analysis.
How Does This Apply to Real Life?
If you’re a man approaching or past 35, this study suggests it may be time to take your heart health more seriously—even if you feel perfectly fine. Consider scheduling a cardiovascular risk assessment with a healthcare provider or a preventive cardiologist, especially if you have a family history of heart disease. Early detection of issues like elevated blood pressure, high cholesterol or early signs of atherosclerosis (plaque buildup in the arteries) can help you take action before problems develop.
Of course, heart health isn’t just a concern for men. Cardiovascular disease remains the leading cause of death for women, too, and the lifestyle habits that protect your heart are beneficial regardless of sex or gender. The study also underscores that cardiovascular health behaviors matter throughout young adulthood—not just in middle age.
Here are some evidence-backed ways that nutrition can support heart health:
- Embrace a Mediterranean or DASH-style eating pattern. Both emphasize fruits, vegetables, whole grains, legumes, nuts, seeds and healthy fats like olive oil—all of which are linked to lower cardiovascular risk.
- Eat more fiber. Soluble fiber from oats, beans, lentils and fruits can help lower LDL (“bad”) cholesterol. Aim for at least 25 to 38 grams of total fiber daily.
- Limit sodium and ultra-processed foods. High sodium intake is linked to elevated blood pressure, a major risk factor for heart disease. Cutting back on packaged snacks, fast food and processed meats can make a big difference.
- Stay active. While not a nutritional factor, physical activity works hand-in-hand with diet. Aim for at least 150 minutes of moderate-intensity exercise per week.
Our Expert Take
A new study in the Journal of the American Heart Association finds that sex differences in cardiovascular disease risk emerge around age 35, with men reaching key heart disease milestones 7 to 10 years earlier than women. These differences persist even after accounting for lifestyle factors, suggesting men in their mid-30s—particularly those with a family history of heart disease—may benefit from proactive heart health screenings. Regardless of sex, prioritizing a heart-healthy diet rich in vegetables, whole grains, healthy fats and fiber, along with regular physical activity, remains one of the best ways to protect your cardiovascular health at any age.
