First author Kiang Liu, a professor at Northwestern Feinberg School of Medicine in Chicago, said the majority of people who maintained a healthy lifestyle in their 20s remain in the low-risk category in their middle-age years.
The study published in the journal Circulation found when the participants' average age was 24, nearly 44 percent had a low cardiovascular disease risk profile, but 20 years later, just 24.5 percent fell into that category.
In addition, 60 percent of those who maintained all five healthy lifestyles reached middle age with a low cardiovascular risk profile, compared with fewer than 5 percent who followed none of the healthy lifestyles.
"The problem is few adults can maintain ideal cardiovascular health factors as they age," Liu said in a statement. "Many middle-age adults develop unhealthy diets, gain weight and aren't as physically active. Such lifestyles, of course, lead to high blood pressure and cholesterol, diabetes and elevated cardiovascular risk."
Notable deaths of 2014 [PHOTOS]