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Cardiovascular Prevention: How Many Years of Life Can Be Gained?

Dr. Jean-François Renucci, a vascular physician at the Timone University Hospital in Marseille and an expert ambassador for Agir pour le Cœur des Femmes, provides an update on the very positive impact of prevention and lifestyle on “healthy aging.”

Cardiovascular Prevention: How Many Years of Life Can Be Gained?

Cardiovascular prevention saves lives—that much is certain.

But what is the actual benefit in terms of overall life expectancy?

We’re living longer, but under what conditions?

And more broadly, is it worth it?

If not, our foundation, Agir pour le Cœur des Femmes, wouldn’t exist...

A very recent law will (finally) strengthen cardiovascular prevention in France. Indeed, the Yannick Neuder Law, whose implementing decree was published very recently (Law No. 2026-668 of July 27, 2026), aims to provide France with a national strategy to combat cardio-neuro-vascular diseases.

But there are still detractors who, not without bad faith, go so far as to claim that taking statins causes cancer. This interpretation stems from the fact that, because statins prevented a fatal heart attack or stroke, people may develop cancer 15 years later. It is true that statins are likely more effective in preventing cardiovascular disease than in preventing cancer.

And yet, even insufficient efforts—for example, to combat smoking—allow us to “kill two birds with one stone” when it comes to these two major causes of mortality.

Over the 25-year period from 1980 to 2004 in France, mortality from cardiovascular disease among people under 65 was cut in half, while mortality from cancer remained stable.

Cardiovascular diseases were by far the leading cause of death, and it was in 2004 that cancer became the leading cause of death in the general population—except among women, where cardiovascular diseases remain the leading cause, with strokes ranking as the number one cause.

Each of these two types of diseases accounts for approximately 30% of deaths.

A study reveals a “disturbing” truth about our longer lives: we spend more years in poor health. According to the latest analysis of the “global burden of disease” by the journal The Lancet, points out that the global gap between healthy life expectancy and total life expectancy has increased from 8.8 years in 1990 to 10.7 years in 2023. This means that a person now spends more than a decade of their life living with a disability or chronic illness. This trend was observed in all countries studied, with the United States and Australia showing the largest gaps.

Musculoskeletal disorders (particularly low back pain), mental health disorders (depression and anxiety), and hearing loss are the main issues observed globally and are driven by risk factors such as high blood sugar, tobacco use, and obesity.

The study:

Five risk factors account for approximately 50% of cardiovascular diseases: high blood pressure, hyperlipidemia, diabetes, smoking, and being overweight or obese.

However, the impact of the presence or absence of traditional risk factors on the estimated lifetime risk of cardiovascular disease and all-cause mortality remains poorly understood.

To answer this question, a very large epidemiological study was conducted. Data from 2,078,948 participants across 133 cohorts, 39 countries, and 6 continents were analyzed. The Global Cardiovascular Risk Consortium: Global Effect of Cardiovascular Risk Factors on Lifetime Risk Estimates. N Engl J Med 2025;393(2):125-138.

The risk of cardiovascular disease and all-cause mortality was estimated up to age 90 based on the presence or absence of five cardiovascular risk factors at age 50: high blood pressure, hyperlipidemia, diabetes, smoking, and being overweight or obese.

Differences in life expectancy (in terms of additional years of life free from cardiovascular disease or death) based on the presence or absence of these risk factors were also estimated. Changes in risk factors were analyzed to predict lifetime differences based on the progression of these factors.

Results:

The lifetime risk of cardiovascular disease was 24% among women and 38% among men with all five risk factors.

When comparing participants with no risk factors to those with all five risk factors, the estimated number of additional years of life without cardiovascular disease was 13.3 years for women and 10.6 years for men; the estimated number of additional years of life without death was 14.5 years for women and 11.8 years for men. Compared with a scenario in which the five risk factors remained unchanged, changing high blood pressure between the ages of 55 and just under 60 was associated with the greatest number of additional years of life free of cardiovascular disease, while a change in smoking status between the ages of 55 and under 60 was associated with the greatest number of additional years of life without death.

The study concluded that the absence of the five classic risk factors at age 50 was associated with a life expectancy more than ten years longer than the presence of these five factors, in both men and women. People who took steps to manage high blood pressure and smoking in middle age gained the greatest number of years of life free from cardiovascular disease and death from any cause, respectively.

This reinforces the importance of prevention.

And before turning to medications—which are almost always necessary—a healthy lifestyle plays an essential role. This was clearly demonstrated in a study tracking American nurses, which examined their health outcomes based on five so-called “key” preventive measures:

- alcohol: 1 drink per day

- no tobacco

- balanced diet

- 2.5 hours of physical activity per week

- screen time < 7 hours per day

For once, protective factors have been taken into account.

If all 5 of these factors are present, the risk is minimal and very low; if none of the 5 are present, the risk of developing cardiovascular disease is nearly 20%.

Here again, there is a cumulative effect in a positive sense: the risk decreases as the number of present factors increases.

In conclusion

By precisely quantifying the effect of cardiovascular risk factors, an international study shows that addressing hypertension, smoking, diabetes, and weight can add up to 14 years to life expectancy. A demonstration of the power of prevention.

Reference

The Global Cardiovascular Risk Consortium Global Effect of Cardiovascular Risk Factors on Lifetime Estimate. N Engl J Med 2025;393(2):125-138.


 
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