Major Heart Study: People Without Risk Factors at 50 Live 13 Years Longer

Protecting Cardiovascular Health May Add 10-14 Years to Life

A striking study analyzing data from more than 2 million people worldwide found that avoiding conventional cardiovascular risk factors adds years to life.

In particular,

1. Hypertension,
2. Diabetes,
3. Smoking,
4. Obesity, and
5. High levels of bad cholesterol

are five major risk factors that can dramatically reduce life expectancy.

The study was published on March 30, 2025, in NEJM .

Study Scope and Participant Profile

• Data from 133 cohort studies involving people in 39 countries and covering 2078948 individuals were used.

• Participants were at least 18 years old and had regularly monitored health data.

• Assessment was based on risk factors at age 50, with time until death or cardiovascular disease followed up to age 90.

Risk Factors and Definitions:

• Hypertension: Systolic blood pressure ≥130 mmHg

• Hypercholesterolemia: Non-HDL cholesterol ≥130 mg/dL

• Smoking: Daily or occasional smoking

• Diabetes: Clinical diagnosis or a new diagnosis based on blood glucose

• Body Mass Index (BMI): <20 classified as underweight; ≥25 as overweight/obesity

Results: Large Differences in Life Expectancy

Comparing people without any risk factors with those who had all risk factors:

• Women :

  • Additional years free of cardiovascular disease: 13.3 years (95% CI: 11.2 - 15.7)

  • Additional years until death from any cause: 14.5 years (95% CI: 9.1 - 15.3)

• Men :

  • Additional years free of cardiovascular disease: 10.6 years (95% CI: 9.2 - 12.9)

  • Additional years until death from any cause: 11.8 years (95% CI: 10.1 - 13.6)

Effects of Individual Risk Factors:

Comparing people with no risk factors with those having just one:

• Not smoking was associated with additional years until death of, for women: 5.6 years, and for men: 5.1 years

• Without diabetes , the figures were, for women: 6.4 years, and for men: 5.8 years

• Without hypertension , for women: 2.9 years, and for men: 2.9 years

These findings indicate particularly pronounced effects of smoking and diabetes on life expectancy.

Opportunities for Change in Midlife: Ages 55-60 Are Critical

For people with risk factors at ages 50-55, the effects of modifying them between ages 55-60 were also examined.

• Controlling hypertensionprovided the greatest gain in cardiovascular disease-free life.

• Stopping smokingproduced the greatest gain in years until death from any cause.

Findings for Türkiye and the Region:

In the NEJM study, Eastern Europe and Russia included Türkiye. Its estimated figures were:

• For women, years of life lost to hypertension: 3.1 years

• For men: 3.3 years

This highlights the importance of early diagnosis and effective hypertension treatment for longevity.

What Should Be Done?

• Avoiding these five conventional risk factors at age 50 may add 10-14 years to life.

• Even reducing these risks in midlife may provide meaningful gains.

• Hypertension and smoking provide the greatest benefits when modified.

Conclusion: Managing Risk Factors Is Key to a Long, Healthy Life

Cardiovascular disease is the world's leading cause of death. The study suggests that eliminating or controlling risk factors helps prevent disease and is also a key to a longer life of better quality.