Historical data indicate that men develop coronary heart disease (CHD) 10 years before women. A recent study in the Journal of the American Heart Association indicates that this sex gap still remains.
Investigators analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, in which US adults aged 18–30 years enrolled in 1985–1986 and were followed through August 2020.
Among 5,112 participants (54.5% female, 51.6% Black) with an average age of 24.8 years at enrollment and a median follow-up of 34.1 years, men had a significantly higher cumulative incidence of cardiovascular disease. They had higher cumulative incidence rates of the cardiovascular disease subtypes of CHD and heart failure compared with women, but no difference in stroke.
Men reached a 5% incidence of cardiovascular disease 7.0 years earlier than women (50.5 versus 57.5 years). CHD was the most frequent cardiovascular disease subtype, and men reached a 2% incidence 10.1 years earlier than women. There were no significant differences in the age at which men and women reached a 2% incidence for stroke (57.5 versus 56.9 years) or a 1% incidence for heart failure (48.7 versus 51.7 years)
Differences emerged in the fourth decade of life and were not explained after accounting for differences in cardiovascular health.
“Sex differences in cardiovascular disease risk are apparent by age 35, highlighting the importance of initiating risk assessment and prevention strategies in young adulthood,” said corresponding author Alexa Freedman, PhD, of the Northwestern University Feinberg School of Medicine.
URL upon publication: https://www.ahajournals.org/doi/full/10.1161/JAHA.125.044922
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Journal of the American Heart Association
Sex Differences in Age of Onset of Premature Cardiovascular Disease and Subtypes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
28-Jan-2026