Plus, an expert cardiologist weighs in on which two are especially worth your attention.
It’s a sobering statistic that’s nonetheless important to know: Someone in the U.S. dies of heart disease every 34 seconds, making it the nation’s leading killer among both men and women, according to national data from the U.S. Centers for Disease Control and Prevention (CDC). But just because the problem is vast doesn’t mean it’s set in stone. Around age 50, five well-established cardiovascular risk factors play an outsized role in shaping health trajectories, recent research shows—but they can be changed over time.
According to a 2025 study published in in The New England Journal of Medicine, these five factors account for roughly half of all cardiovascular disease cases worldwide:
- High blood pressure
- Elevated cholesterol
- Abnormal body weight (high or low)
- Diabetes
- Smoking
The researchers behind the study, credited as The Global Cardiovascular Risk Consortium, looked at the impact of these factors and found that arriving at midlife with all five can greatly hinder both lifespan and healthspan—meaning overall survival and the number of years that a person lives in generally good health.
Reviewing data from over two million subjects across 39 countries, the researchers determined that being free of these core risk factors at age 50 was associated with 14.5 additional years of life in women, and 11.8 additional years of life in men.
Additionally, among those with all five risk factors, the lifetime risk of cardiovascular disease was remarkably high: 24% in women and 38% in men. The researchers noted that women free of all five risk factors enjoyed 13.3 additional heart disease-free years, while men added 10.6 heart disease-free years to their lives.
Importantly, the findings also highlight the benefits of change. Even when risk factors are present at age 50, improvements made during the following decade can meaningfully impact outcomes.
Christina Magnussen, MD, a cardiologist, professor, and a lead study author, recommends focusing on “two main risk factors” in particular: hypertension and smoking. Controlling high blood pressure in the latter half of one’s fifties yields some of the largest gains in cardiovascular disease-free years, while quitting smoking during that same window offers the greatest benefit for overall longevity, the study authors note.
“Our aim was to do this calculation for a global population and also…to overcome these static estimates and show what is possible if these risk factors are modified,” Dr. Magnussen said in a May 2025 podcast interview with the American College of Cardiology.
Following a healthy diet, exercising regularly, and taking medications as prescribed by your doctor are also crucial steps toward maintaining—or reclaiming—better heart health. The American Heart Association (AHA) adds that if you have multiple risk factors, it’s especially important to work with your doctor toward reducing your risk: “You and your health care team can build a prevention plan that works for you.”
It’s also never too early to start practicing heart healthy habits, says Dr. Magnussen. “Lifetime risk is substantial, even in individuals without any of the risk factors—so I think prevention has to start early in life and perhaps also independently of high cardiovascular risk,” she says.
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