Smoking, cholesterol and high blood pressure are still high-risk factors for the over-50s, according to research published in the online British Medical Journal (BMJ).
The three combined can reduce life expectancy by 10 years, and up to 15 years for those who are also overweight and have other underlying health issues.
The report says that although a government target to cut heart disease deaths among under-75s 40% by 2010 has been met, the Care Quality Commission (CQC) is seeking to do more.
The research found that men with all three risk factors are three times more likely to die from vascular disease than those without, and that changes in diet and lifestyle and better treatments substantially reduces heart attacks.
The study followed 18,863 men for 38 years. By 1997, 13,501 had died. Of the remainder, two-thirds of those who had previously been smokers had given up.
It concludes that those who smoked and had raised cholesterol and blood pressure at the start of the study had a 10-year shorter life expectancy from the age of 50.