Men's cardiovascular disease risk begins pulling away from women's as early as age 35, and men reach a meaningful risk threshold about seven years earlier on average, long before most notice any symptoms.
That is the finding of a new analysis of more than 5,100 adults followed for over three decades in the CARDIA cohort, published January 28, 2026 in the Journal of the American Heart Association.
Men in the study hit a 5% cumulative incidence of cardiovascular disease at age 50.5, while women reached the same threshold at 57.5.
For coronary heart disease specifically, the type that leads to heart attacks, men crossed a 2% incidence more than 10 years earlier than women.
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For men in their late 30s and early 40s, that shifts the conversation with a primary care doctor toward earlier checks on blood pressure, fasting lipids, and fasting glucose.
What the CARDIA data actually shows
The Coronary Artery Risk Development in Young Adults study enrolled 5,112 Black and white adults aged 18 to 30 in 1985 and 1986 and followed them through August 2020, a median of 34.1 years.
Roughly 54.5% of participants were women, and 51.6% were Black.
Through their early 30s, men and women in the cohort carried a similar cardiovascular risk.
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Around age 35, the trajectories split. Men's risk of a first cardiovascular event, defined broadly to include heart attack, stroke, and heart failure, rose faster and stayed higher through middle age.
Not every subtype told the same story. Coronary heart disease drove most of the gap.
Stroke risk showed no meaningful sex difference during the follow-up, and heart failure differences appeared only at older ages.
Blood pressure and cholesterol only explain part of it
The researchers tested whether the classic risk factors could account for the divergence. They could not, at least not on their own.
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Adjusting for blood pressure narrowed the sex-based gap by about 15%, and glucose control and diet quality each accounted for roughly 14%.
When the team adjusted for an overall cardiovascular health score, the reduction was just 2.9%, meaning most of the earlier onset in men remains unexplained by the standard checklist.
It remains unclear what the driving factors are for the earlier development of heart disease in men.
What men in their 30s and 40s can do now
The study argues that standard screening approaches focused on adults over 40 may miss a critical window.
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The American Heart Association's PREVENT risk equations are validated for use starting at age 30, which the authors point to as a way to estimate long-term cardiovascular risk earlier.
Practical steps for a man in his mid-30s to mid-40s who has not been screened recently: book a preventive visit, ask for a fasting lipid panel and a fasting glucose test, and have blood pressure checked and tracked over time, rather than treated as a one-off number.
Adults with a family history of early heart disease should mention it, because it changes how a doctor weighs the results.
Home monitoring can support that tracking, and regular home blood pressure measurement has been linked to lower heart attack risk in earlier research.
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Anyone with chest pain, breathlessness, or symptoms that concern them should see a doctor rather than wait for a scheduled check.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.