But having an "optimal" risk factor profile at age 45 staved off heart disease for about 14 years, compared with having at least two major risk factors in middle age, says researcher John T. Wilkins, MD, of Northwestern University Feinberg School of Medicine in Chicago.
What's optimal, or best? Having a blood pressure reading under 120 over 80, a cholesterol level under 180, and no diabetes, as well as being a nonsmoker.
Even people who watch all their risk factors may eventually develop cardiovascular disease. The study showed that even in men and women with an optimal risk factor profile, the lifetime risk for cardiovascular disease was still 30% or greater for both sexes.
"Still, if you have fewer risk factors, you will live healthier longer," Wilkins says.
The findings appear online in the Journal of the American Medical Association.
Previous studies have shown that your health in middle age influences your future risk of various types of heart disease; and that the more risk factors you develop during middle age, the greater your risk in old age.
The new study is the first to look at the risk of all types of cardiovascular disease, including heart attacks, other types of coronary heart disease, stroke, and congestive heart failure and death due to any of these conditions.
For the study, researchers pooled data from five National Heart, Lung, and Blood Institute-funded, community-based studies that involved about 50,000 men and women.
Among other findings:
Women had lower lifetime risks than men at all ages.
Past American Heart Association President Sidney Smith, MD, of the University of North Carolina at Chapel Hill, says the study "offers an important message that emphasizes the value of a healthy lifestyle that lowers heart disease risk factors."