A new study found that young adults in good cardiovascular health tended to maintain it as they got older.
Building heart-healthy habits early in life is strongly linked to lower risk of heart attack and stroke in later adulthood. In a study published October 6 in JAMA Network Open, researchers followed 4,241 participants who were 18 to 30 years old at baseline for nearly 40 years to track long-term cardiovascular health patterns. By about age 25, most people had already settled into consistent behaviors and health profiles that persisted over time.
Investigators used the American Heart Association’s Life’s Essential 8 (LE8) score — a composite of behaviors and clinical measures including smoking status, physical activity, diet, sleep, body mass index, blood pressure, cholesterol, and blood glucose — to assess cardiovascular health. High LE8 scores indicate good cardiovascular health; low scores indicate poorer health.
Participants clustered into four distinct LE8 trajectory groups across adulthood:
– Persistent high — high score at baseline that remained high
– Persistent moderate — mid-level score that stayed stable
– Moderate declining — mid-level score that worsened
– Moderate/low declining — moderate to low score that declined further
The trajectories remained separated over time, meaning patterns established in young adulthood tended to persist. Compared with the persistent high group, each lower trajectory showed progressively greater incidence of cardiovascular events. Those in the least favorable (moderate/low declining) group had about a tenfold higher risk of developing cardiovascular disease later in life.
Lead author Donald M. Lloyd-Jones, MD, noted that people with high LE8 scores generally maintained them, while those with worse scores at the start often declined. Eiman Jahangir, MD, MPH, who was not involved in the study, highlighted that cardiovascular health set by age 25 is difficult to change later, underscoring the importance of early education and preventive measures.
The study also found that individuals whose LE8 scores improved or worsened over time did not differ significantly from the middle-scoring group, suggesting some lasting effects of early-life cardiovascular health. This implies that correcting poor early habits later may not fully erase elevated risk.
Implications
The findings emphasize beginning heart-healthy habits in young adulthood or earlier. Starting early increases the likelihood of staying in the highest cardiovascular health group across the life course, resulting in longer life and fewer chronic diseases. However, researchers stress it is never too late: improving habits later still reduces risk, even if earlier advantages are harder to recover completely.
Practical steps include following Life’s Essential 8 factors — remain physically active, eat a healthy diet, avoid tobacco, get adequate sleep, and manage weight, blood pressure, cholesterol, and blood glucose. Regular medical checkups for blood pressure and cholesterol, counseling on diet and exercise, and tobacco cessation remain central to primary prevention.
Consult your healthcare provider to determine the best individualized plan. Early prevention offers the greatest benefit, but lifestyle improvements at any age can help protect heart health.
