Men develop cardiovascular disease (CVD) significantly earlier than women, with risk diverging as early as the mid-30s and persisting through midlife, according to a study published in the Journal of the American Heart Association.
Researchers analysed data from 5,112 US adults enrolled in the CARDIA study between 1985 and 1986, when participants were aged 18 to 30, with follow-up extending through 2020. The study examined sex-based differences across CVD subtypes, including coronary heart disease (CHD), stroke, and heart failure.
Overall, men reached a 5% cumulative CVD incidence approximately seven years earlier than women. CHD was identified as the primary driver of this gap, with men reaching comparable CHD incidence thresholds roughly a decade earlier than women. By contrast, stroke and heart failure incidence occurred at broadly similar ages across sexes, though the authors noted these conditions tend to emerge later in life, and the study population had not yet reached the ages at which they become most prevalent.
Notably, the male-female divergence in CVD rates appeared around age 35 and was not fully explained after adjusting for established cardiovascular risk factors such as blood pressure, cholesterol, and smoking. This suggests that additional biological or social factors may contribute to the observed differences.
The authors suggest that the fourth decade of life may represent a critical window for cardiovascular risk assessment in men, and that earlier screening could support timely identification of risk factors. The findings are based on a US cohort and may not be generalisable to other populations.
Published in: Physicians Weekly and Journal of the American Heart Association.
