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Following a healthy lifestyle before you are “over the hill” could save you a lot of grief. A study described in the February issue of Circulation: Journal of the American Heart Association found that major risk factors for heart disease—high blood pressure, elevated cholesterol, diabetes, and being overweight—increase the odds of developing cardiovascular disease (CVD) if one or more of these factors are present at middle age.

At age 50, the average lifetime risk of developing CVD before age 95 is 52 percent for men, 39 percent for women. Add a risk factor, and the percentages rise. Men who had two or more risk factors by middle age had a lifetime risk of 69 percent and for women, 50 percent. Those who arrived at the midpoint of their lives relatively healthy, however, dramatically improved their outlook.

“Men whose risk factors were optimal at age 50 had a remaining lifetime risk of only 5 percent. Essentially, their risk of CVD had been abolished,” explains lead author Donald Lloyd-Jones, MD, ScD, assistant professor of preventive medicine.

Dr. Lloyd-Jones’ research also showed that men and women who at age 50 had optimal risk factor levels had a median survival of longer than 39 years. Those with two major risk factors had median survival rates of 28 years for men and 31 years for women.

“Clearly, prevention efforts need to begin decades before age 50, since even the presence of a single major risk factor substantially raises the lifetime risk for CVD and offers a markedly shorter survival,” says Dr. Lloyd-Jones.