• Posted October 9, 2025

Health Habits In 20s, 30s Can Have Dramatic Effect On Later Heart Attack, Stroke Risk

The healthy habits people adopt and stick with in their 20s and 30s have a massive and direct impact on their risk of a heart attack or stroke decades later, a landmark study says.

Young adults who fail to keep heart-healthy practices can see their risk of future heart disease skyrocket by as much as 10 times as they age, compared to those who maintain their healthy habits, researchers reported Oct. 6 in JAMA Network Open.

“Change matters: Improvements in heart health can decrease future risk, and the earlier it is attained and maintained, the better, ” senior researcher Dr. Donald Lloyd-Jones, a professor of medicine at Boston University School of Medicine, said in a news release.

“We hope that young adults will focus on their heart health as soon as possible, in order to gain the biggest dividends in longer, healthier lives,” he added.

For the study, researchers tracked more than 4,200 adults participating in a long-term study of heart health. The participants joined the study in 1985 and 1986, when they were 18 to 30 years old. They were followed for 20 years.

The team specifically looked at the participants’ adherence to Life’s Essential 8, a guideline for heart-healthy habits established by the American Heart Association.

The eight recommendations include eating healthy, getting more physical activity, quitting tobacco, sleeping well, managing weight, and controlling cholesterol, blood sugar and blood pressure.

Researchers put the participants into one of four categories, based on how well they followed these habits over time. Participants could consistently remain very healthy or less healthy, or their heart-healthy habits might improve or decline over the years.

Results showed that that those whose heart health habits declined from moderate to low over time had a 10 times greater risk for heart attack, stroke or heart disease.

By comparison, people who maintained moderate heart health habits had twice the risk of heart health problems, and those with steadily poor heart health habits had nearly six times the risk, the study showed.

Each 10-point decrease a person experienced in their Life’s Essential 8 score during the study’s 20-year span increased their heart health risk by 53%, researchers found.

"The main point is that we need to stop and take care of ourselves better earlier in life by addressing our sleep habits, physical activity, BMI [an estimate of body fat based on height and weight] and our lipids in that 18 to 30-year-old range and not waiting until you're 45 to go see a cardiovascular expert or a cardiologist, but seeing them early on in life when you can still make an impact on what is going to come down stream," said Dr. Gaurav Rao, director of the Cardiac Cath Lab at Huntington Hospital in New York, who reviewed the findings.

Unfortunately, many folks have a problem predicting the future impact of their current life choices, he said.

“The general population usually, whether it's just due to lifestyle creep, tends to not realize that those effects can be prolonged and they think they can turn off that switch at some point and start living a healthier life as they get older,” Rao said.

“However, this study itself, the main takeaway that it brings to light is that we are not immune from our earlier decisions with respect to cardiovascular health,” he said.

While change later in life can help your health, changes adopted earlier will have a more profound and lasting effect, Rao said.

“The earlier they reverse those patterns, the better their trajectory is when it comes to cardiovascular health, he said. “For example, if they reversed it in their late 20s to early 30s, that is much better than reversing it in their 40s to 50s because usually, cardiovascular disease is cumulative.”

Rao pointed to cholesterol levels as an example.

“Having persistently elevated cholesterol for a longer period of time can lead to a higher incidence of coronary disease,” Rao said. “If you get a grapple on that earlier, you can plateau the risk and help your trajectory in the long run.”

More information

The American Heart Association has more on Life’s Essential 8.

SOURCES: Boston University, news release, Oct. 6, 2025; Northwell Health, news release, Oct. 6, 2025