Is It Too Late to Change or Can We Turn Things Around Even after Age 55?
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When it comes to preventing disease, there are controllable and non-controllable or non-modifiable and modifiable factors that affect our health and our ability to live long, healthy.
Many factors such as our genes and our environment are not in our control as these images show.
But what “I” or we do on a daily basis is under our control and these are the factors that we can modify or improve upon to live long, healthy. These include being physically active, eating sensibly, controlling salt and sugar intake, not falling, managing our senses, sleeping well, taking vaccines, not smoking, not drinking or drinking in moderation and calming our minds and building cognitive reserves. What we do matters.
We intuitively know this, but what we don’t often know is how much more are we likely to live if we change these modifiable factors only after we turn 50 or 55.
The New England Journal of Medicine (NEJM) just 3-4 days ago, published a very interesting article titled, “Global Effect of Cardiovascular Risk Factors on Lifetime Estimates” [1]. They looked at 5 modifiable factors and the risk of cardiovascular diseases, cardiovascular disease-free survival and all-cause or overall mortality.
The five factors are:
- absence of arterial hypertension (systolic blood pressure < 130 mm Hg)
- absence of hyperlipidemia (non-HDL cholesterol less than 130 mg/dl)
- absence of diabetes
- absence of smoking
- absence of underweight or overweight or obesity
At age 50, men who had none of these risk factors lived 10.6 years longer without cardiovascular disease than those with all 5 risk factors, while for women, the difference was 13.3 years. More importantly, men with none of these risk factors lived 11.8 years longer, while women, 14.5 years longer than their peers who had all these risk factors. Those who had only 2 or 3 of these risk factors were in-between.
More importantly, those who modified their risks between ages 55 and 60 also gained. Those who stopped smoking gained the most, followed by high blood pressure control, with additional years gained depending on how many more factors were controlled.
This is in line with the conclusion of a paper [2] I had written about in Nov 22, which stated, “smokers who stopped smoking between the ages of 45 and 64 had a 66% reduction in the excess mortality risk associated with smoking.
High blood pressure is the single biggest killer in India, after air pollution. It makes sense that controlling blood pressure perhaps is the next most important modifiable risk factor.
What this paper does not tell us as with most such studies is how much more we would gain if we just added physical activity to the mix.
What does the mean for you and I? Many of us, especially those of us currently in our 60s did not really take care of our health or even start thinking about the concept of living long, healthy until we turned 50. Many of us often wonder if it is worth changing now and whether that will make a difference to any damage already done.
The good news is that even if we start modifying these factors after the age of 55, there is significant benefit, the two most important factors being one act of omission (not smoking) and one act of commission (managing blood pressure). Just as with physical activity, it is never too late to start changing things.
Footnotes:
- Global Cardiovascular Risk Consortium; Magnussen C, Alegre-Diaz J et al. Global Effect of Cardiovascular Risk Factors on Lifetime Estimates. N Engl J Med. 2025 Mar 30. doi: 10.1056/NEJMoa2415879.
- Thomson B et al. Association Between Smoking, Smoking Cessation, and Mortality by Race, Ethnicity, and Sex Among US Adults. JAMA Netw Open. 2022 Oct 3;5(10):e2231480.