An online lifestyle tool could help assess the risk of future heart disease in young adults, according to a recent study published in the Journal of the American Medical Association.

The study, led by researcher Holly C. Gooding, MD, MS, evaluated the effectiveness of the Healthy Heart Score (HHS) calculator in adults between 18 and 30 years old. The tool was created by investigators at Harvard University and aims to assess an adult’s risk of developing atherosclerotic cardiovascular disease (ASCVD) before age 55.

Gooding and her colleagues pulled a sample of 4,893 American adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study in the spring of 1985 and asked the patients to evaluate their lifestyles using the HHS tool for roughly a year. Of those nearly 5,000, 54.9 percent were women, 50.7 percent were black and all were an average of 25 years old at the beginning of the study. The patients were monitored for 27 years until data was finalized and analyzed in 2016.

According to the study, the HHS was most successful when evaluating healthy, younger adults, men, white populations and those without baseline clinical ASCVD risks. According to Gooding’s research, 427 individuals—8.7 percent of the total pool—already had at least one clinical risk factor when the study began, including hypertension, hyperlipidemia and diabetes.

The HHS bases its results on participants’ weight, physical activity, smoking status, alcohol use and diet, according to the Harvard T.H. Chan School of Public Health. It uses a sex-specific calculation model, and all information inputted into the online tool is self-reported by patients themselves.

The HHS differs from the established Framingham Risk Score in that it claims to identify future risk factors for more than 20 years into the future and uses information that the patient already knows about their lifestyle habits, while the Framingham equation calculates risks a decade ahead and requires a doctor to take the patient’s blood pressure and cholesterol levels. The HHS also provides patients with counsel, personalized suggestions to lower risk of heart attacks and strokes, and reinforces already healthy habits.

Gooding called the HSS an “attractive tool” in her findings, noting it performed moderately well in assessing ASCVD risks in younger adults. Still, 64 women and 99 men—all of whom had poorer HHS scores—experienced premature ASCVD events during the study.

“It is not surprising that the factors in the Healthy Heart Score—diet, exercise, smoking, alcohol and body mass index—predict heart disease in the future,” Gooding told Reuters Health. “What is surprising is how well those lifestyle factors measured before the age of 30 years can predict the risk of heart disease, even in young adults without other risk factors for heart disease like hypertension, high cholesterol and diabetes.”