March 2025: Global Effect of Cardiovascular Risk Factors on Lifetime Estimates
The issue
Five common, modifiable factors — high blood pressure, high “bad” cholesterol, unhealthy weight (either too low or too high), diabetes, and smoking — account for roughly half of all cardiovascular disease worldwide. When all five are present at age 50, lifetime risk of heart attack or stroke jumps to 24 % in women and 38 % in men.
What do I need to know?
Researchers pooled data on more than two million people from 133 cohorts across 39 countries. Compared with peers who had every risk factor, adults who entered their fifties with none lived, on average, 13.3 extra years free of cardiovascular disease (women) and 10.6 extra years (men), and roughly the same additional years free of death from any cause. Mid‑life changes matter: lowering high blood pressure between ages 55–60 added the most disease‑free years, while quitting smoking added the most overall life‑years.
Potential risk of cardiovascular disease
An older adult has no more than one of the five risk factors and no prior heart problems.
Recommended Actions
Check blood pressure, cholesterol, weight, blood sugar, and smoking status at every annual visit.
Maintain a healthy diet and 150 minutes of moderate activity per week.
Discuss vaccinations and stress management to keep inflammation low.
Imminent risk of cardiovascular disease
The person has two or three risk factors (e.g., hypertension plus diabetes) but no prior event.
Recommended Actions
Set targets: systolic blood pressure < 130 mm Hg, non‑HDL cholesterol < 130 mg/dL, and BMI 20–25.
Start or intensify medications (ACE‑inhibitor/ARB, statin, metformin) per physician advice.
Create a quit‑smoking plan; consider nicotine replacement or counseling.
Re‑check labs and blood pressure in three months.
Confirmed cardiovascular disease risk burden
Four to five risk factors or any history of heart attack, stroke, angioplasty, or heart failure.
Recommended Actions
Follow guideline‑directed therapy (combination blood‑pressure drugs, high‑intensity statin, low‑dose aspirin if appropriate, glucose‑lowering agents with proven cardiac benefit).
Enroll in cardiac rehabilitation or a supervised exercise program.
See a dietitian for Mediterranean‑style meal planning and weight control.
Monitor blood pressure and glucose at home; report readings outside agreed limits.
What can I do?
Ask your doctor: “Which of the five risk factors do I have, and am I at potential, imminent, or confirmed risk?” Bring recent home blood‑pressure logs, a current medication list, and note any tobacco use. If blood pressure is high, work toward the < 130 mm Hg goal; even a five‑point drop lowers lifetime risk. If you smoke, quitting at 55–60 yields the greatest survival gain, but stopping anytime helps. Schedule follow‑ups to track progress, and celebrate each controlled risk factor as a decade‑long investment in extra healthy years.
