Want to have a healthy heart in your senior years? Take care of it while you’re young. That’s the message from a huge study of more than a quarter of a million men and women.

Northwestern University researchers determined how many major risk factors for heart disease each individual in the study had at ages 45, 55, 65, and 75. These risk factors included high blood pressure, high cholesterol, smoking, and diabetes. Then they determined the chances of having a heart attack or stroke over the remaining life span. The results were remarkable.

A 45-year-old man who had normal blood pressure and cholesterol levels, who didn’t smoke, and who didn’t have diabetes had just a 1.4% chance of having a heart attack or stroke during the rest of his life. Having one major risk factor boosted the risk 20-fold (see table). The results were similar for men and women, blacks and whites.

“If you make it to middle age with an optimal profile, it’s really like the fountain of youth for your heart,” lead researcher Dr. Donald Lloyd-Jones, chair of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago, told HealthDay.

For me, this study has two important take-home messages:

• The seeds of heart disease are sown early.
• A lifetime of healthy living can have a huge payoff.

Lifetime vs. 10-year risk

Doctors traditionally use risk factors like smoking and high cholesterol to estimate a person’s chances of having a heart attack or stroke, or dying from one, over the next 10 years. This is a simple procedure that can be done using paper and pencil or an online calculator. The estimate helps guide how intensively these risk factors need to be modified. For example, if your 10-year risk is high, the target for your cholesterol is low and usually requires medication to get there. If the 10-year risk is low, diet alone is often sufficient to control cholesterol.

The Northwestern team looked at the more important lifetime risk for heart attack, stroke and other conditions related to artery-clogging atherosclerosis. Development of simple methods for calculating lifetime risk could be a big help in fighting heart disease.

Early prevention is best, but it’s never too late

For decades, we’ve known the importance of modifying the 4 major heart risk factors by:

• not smoking
• losing weight and exercising more, especially when blood sugar begins to climb
• controlling blood pressure
• lowering cholesterol with diet, and medication if necessary

All too often, we do this only after a problem has appeared. The Northwestern study highlights that our real goal should be preventing these problems from appearing in the first place. In other words, we need to get our children and young adults off to a healthy start, which gives them a fighting chance to get to middle age with healthy blood pressure and cholesterol levels, no diabetes, and not smoking.

Having risk factors in middle age does not mean that your fate is set. You might not get 100% return on investing in your lifestyle and taking medications, if necessary. But tackling heart disease risk factors in middle age and beyond still pays great dividends.

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