Premature Heart Disease Occurs Sooner in Men Than Women, Research Reveals - Video

A recent study published in the Journal of the American Heart Association examined when sex-based differences in the onset of premature cardiovascular disease (CVD) emerge and how these differences evolve across adulthood. Cardiovascular disease remains a leading cause of death in the United States and often develops silently over decades.

Historically, men have been diagnosed with heart disease earlier than women, with female sex hormones thought to provide some protection. However, changing lifestyle patterns—including rising obesity, diabetes, and hypertension among women—have raised questions about whether early-life cardiovascular risks are becoming more similar between sexes. This study aimed to clarify when these risk differences begin.

Researchers analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective cohort that enrolled Black and White adults aged 18–30 years from four U.S. cities between 1985 and 1986. Participants were followed for more than 34 years, with cardiovascular events tracked through August 2020.

The primary outcome was new-onset, clinically confirmed CVD before age 65, including heart attack, stroke, heart failure, coronary revascularization, and transient ischemic attack. Cardiovascular health was assessed using the American Heart Association’s Life’s Essential 8 framework, excluding sleep.

Among 5,112 participants, men developed premature CVD significantly earlier than women. Men reached a 5% cumulative incidence of CVD approximately seven years sooner. By age 50, nearly 5% of men had experienced a cardiovascular event, compared with fewer than 3% of women.

Coronary heart disease accounted for most of the disparity, with men reaching a 2% cumulative incidence more than a decade earlier than women. In contrast, stroke risk showed no major sex differences, while heart failure differences emerged later in life.

Sex-based differences in premature CVD emerge in the mid-30s, driven mainly by earlier coronary heart disease in men. The findings underscore young adulthood as a critical window for early cardiovascular prevention in men, while emphasizing the continued importance of heart health across the lifespan for women.

REFERENCE: Freedman, A. A., Colangelo, L. A., Ning, H., Borrowman, J. D., Lewis, C. E., Schreiner, P. J., Khan, S. S., & Lloyd-Jones, D. M. (2026). Sex Differences in Age of Onset of Premature Cardiovascular Disease and Subtypes: The Coronary Artery Risk Development in Young Adults Study. Journal of the American Heart Association. DOI: 10.1161/JAHA.125.044922. https://www.ahajournals.org/doi/10.1161/JAHA.125.044922