Between 1964 and 1973, thousands of healthy Finnish men, most of them around 42, went in for a checkup. Researchers at the University of Helsinki kept track of 2,690 of them for more than 50 years. Of the men whose cardiovascular health was good on all five measures, 42% lived to 90. Of those who were good on none, about 7% did.
The men who started with the best numbers were also less frail in old age, the team reported on Aug. 27 in the European Journal of Preventive Cardiology. The evidence that they were happier is weaker.
Five numbers from a 1960s checkup
The five measures were smoking, body mass index, blood pressure, cholesterol and blood glucose. To count as low risk on all five, a man had to be a nonsmoker with a BMI under 25, a systolic blood pressure under 140, total cholesterol under 6 mmol/L, about 232 mg/dL, and blood sugar under 9.0 mmol/L an hour after a glucose drink, the paper says.
Those limits are loose by today’s standards. The authors note that a systolic reading of 120 to 139 is now considered elevated, and they say they set the cholesterol cutoff where they did because Finnish cholesterol levels were high in the 1960s.
The men were born between 1919 and 1934 and belong to the Helsinki Businessmen Study. All of them were free of chronic disease at that first checkup, and they went on to take very different paths through aging.
A gap of 35 points at 90
Few men sat at either end. Only 105 had all five low-risk factors at the start and 59 had none, according to the paper. Most had two or three.
The share who reached 90 rose with each factor: 6.8%, 14.2%, 18.3%, 26.7%, 36.6% and 41.9%. Counting from that first checkup and adjusting for age, the men with no low-risk factors lived about 32 more years on average and the men with all five about 43.
Mortality records ran through Jan. 31, 2025. By then 2,524 of the men, 93.8%, had died, and all of them had been born early enough to reach 90.
Frailty at 79
In 2007, when the survivors were 79 on average, 907 of them answered a survey about their health, daily function and mood. That was 63% of the men still alive, and the response rate was similar across the groups, the authors report. The 2007 figures describe only the men who were still alive and answered.
Frailty was scored from the survey answers, using an adapted version of a standard clinical definition. Among respondents who had all five factors in midlife, 2.2% were frail. Among those with zero or one, 24.5% were. The five-factor group was small by then, 54 men, so its 2.2% comes to about one man.
The university describes frailty as a state in which the body’s functional capacity and its ability to withstand strain or stress are reduced.
“The common adage is that you either live a short and pleasant life, or a long and unpleasant one,” said Timo Strandberg, a professor emeritus at the University of Helsinki and HUS Helsinki University Hospital who led the study, in the university’s announcement. “This study indicates that healthy lifestyles can add both years and functional capacity to your life.”
Happier, but not clearly
On a happiness scale from 0 to 10, the five-factor group averaged 7.98 and the zero-to-one group 7.41. The p-value for that comparison was 0.053, just above the usual 0.05 cutoff for statistical significance. The university’s announcement still put happiness in its headline.
Psychological well-being, scored from six questions about things like zest for life, loneliness and plans for the future, was positive in 55.1% of the five-factor group and 39.0% of the zero-to-one group. That difference did reach significance.
The study did not test whether controlling cholesterol or blood pressure later in life changes how happy anyone feels.
What the study can’t show
The men were white, Finnish and, in the authors’ words, “of high social class.” The paper says it is not known whether the results apply to women. It is an observational study, so it shows associations, not cause and effect.
The authors also write that they could not assess the impact of genetics and early life factors. Their low-risk men got that way through lifestyle or genes, because statins and modern blood pressure and obesity drugs did not exist in the 1960s. Whether drugs can bring the same gains in quality of life remains uncertain, the paper says, though it adds that trial evidence suggests they can, at least for physical function.
Numbers anyone can check
Strandberg pointed out that all five can be measured at an ordinary visit. “The body mass index, smoking, cholesterol, blood pressure and blood glucose can all be measured and addressed. If not through lifestyle choices, then with safe and mostly inexpensive drugs,” he said in the announcement. According to the university, he sees the study as new motivation to address risk factors before problems arise.
The paper sets its five measures alongside the American Heart Association’s Life’s Essential 8, which adds diet, physical activity and adequate sleep to the same list.
Some of the men are still alive. As of January 2025, 150 of them could still reach 95 or 100, the paper says, and the authors put the share of the cohort that could become centenarians at under 5%.
Photo: Shixart1985 / Wikimedia Commons (CC BY 2.0)
