Cardiovascular disease (CVD) is still the world's number one cause of death. But did you know that five everyday risk factors may play an outsized role in determining not just if you’ll get heart disease, but how long you’ll live? A global study published in *The New England Journal of Medicine* in 2025 offers powerful new insights into how managing your health by age 50 could help you live a longer, healthier life.

Researchers analyzed health data from over 2 million adults across 39 countries to evaluate how five common health risk factors—high blood pressure, high cholesterol, unhealthy weight (underweight or obesity), diabetes, and smoking—affect a person’s lifetime risk of cardiovascular disease and death from any cause. They found that people with all five risk factors at age 50 were much more likely to develop CVD or die earlier than those without any of them.

Here’s the most striking part: women with no risk factors lived, on average, 13.3 more years free of heart disease and 14.5 more years without dying from any cause than women with all five risk factors. Men with no risk factors gained 10.6 more years free of heart disease and 11.8 more years without death. That’s more than a decade of healthy life—just from managing five things by midlife.

Even more encouraging, the study showed it’s never too late to make a difference. People who improved their blood pressure or quit smoking between the ages of 55 and 60 still gained several extra years of life and health. In fact, quitting smoking at that age added the most years free of death, while lowering blood pressure added the most years free of cardiovascular disease.

These findings are clearly illustrated in the figure below. It compares four groups: men and women with none of the five risk factors, and men and women with all five. Solid lines represent healthier individuals; dashed lines show those with all risk factors. The graphs demonstrate that staying healthy into midlife significantly delays the onset of disease and improves survival across the board.

Figure: Lifetime risk and survival by sex and risk factor profile. Solid lines represent individuals with no risk factors; dashed lines indicate those with all five.

The takeaway? Taking care of your heart doesn’t require magic—it requires managing five key risks. Check your blood pressure, monitor cholesterol, maintain a healthy weight, prevent or control diabetes, and don’t smoke. Even small changes can add up to big differences in how long—and how well—you live.