Heart’s “fountain of youth” starts flowing early

Howard LeWine, M.D.

Chief Medical Editor, Harvard Health Publishing

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.

At age 45

All risk factors optimal

1 major risk factor

2 or more major risk factors










Related Information: Harvard Heart Letter


  1. health ecology

    This is a very helpful article, It’s pretty simply really, if you want a long health life you must put in your body the fuel needed to accomplish that.

  2. Anonymous

    Switching to a healthier lifestyle at any age helps. My father smoked for years, and was overweight. He finally decided to get healthy. He stopped smoking, changed his diet, and started exercising. He says he feels thirty years younger! There’s always hope.

    • Preshemie


      My husband had to quit smoking 3 or 4 months ago. He had to quit coz he had a hard time breathing that time and I had bad sinus infection and it was the one causes it. And now he starts smoking again. He said he has to smoke again coz he is stressed and bored. But, I told him that I don’t a problem with it as long as he don’t have to smoke inside the bedroom, house, and the car, and he agreed that he will smoke outside the house. And now, it’s been days that he is smoking again inside the bedroom and my head started to hurt and I think it is my sinus again. I told him to smoke outside especially when I am sleeping coz it woke me up in the middle of the night when I smell the smoke, and besides it is not good also for my daughter sniffing his cigarette smoke inside the house. He said that it is not true that second hand smoking is bad. But I kept on telling him that it really bothers me every time I smell the cigarette smoke. He got angry that I kept on complaining. What am I gonna do? How am I gonna convinced him not to smoke inside the house again?

  3. RonSmith

    If you want to live A good and healthy life you must take part in daily activities actively with a passion to do more next time.

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  4. Bob bramel

    So much conventional wisdom, so little useful info. Specifically:
    Don’t smoke. No argument there.
    Lose weight. Obviously, but how? HNL won’t promote the only truly effective way, which is to reduce insulin levels so adipose tissue will quit sucking up calories.
    Control blood pressure. Never mentioned but most effective is cutting carbs. Published studies warn that low carbing may cause “low blood pressure” Why, insulin tells the kidneys to retain sodium and that causes the kidneys to retain fluid.
    Lower cholesterol. Not necessarily! Instead, first get an EBCT! High cholesterol (mine is currently 599, and that is not a typo) does not always mean clogged arteries ( mine are whistle clean at age 66). By conventional medical screening my heart attack risk is astronomical, but by actually visualizing coronary arteries my risk is one in a thousand. Who knows how many people are taking statins, with all the known risks, for no benefit, because they were never going to develop atherosclerosis anyway? Statins never were “harmless” and now the FDA has made it official.

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  6. Aria

    Life is short enough, if folks would just learn to eat the right foods and stop putting poisons in their bodies. It’s pretty simple really, if you want a long health life you must put in your body the fuel needed to accomplish that. I stick to a very healthy diet plan I got from home remedies for thrush. To put it simply, it works.

  7. Karene

    My sister smoked all her life and I did not and when we each went through menopause, she had a terrible time and mine was relatively the way you would expect.

  8. Terry Marie

    I am a retired nurse and I have seen the effects of smoking on the body, especially on the menopausal age women. Menopause is difficult enough without complicating things.

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