Recent research indicates that the buildup of artery-clogging plaque may start much earlier than previously believed. Approximately 1 in 13 adults aged 18 to 29 already have silent atherosclerosis, the hardening of arteries due to plaque, despite having no known cardiovascular disease. Furthermore, more than half of all healthy adults in the study displayed signs of plaque in their arteries. This significant international study was conducted by researchers in Denmark and Spain.
Using advanced imaging techniques, the study examined over 16,800 adults aged 18 to 70, all without known cardiovascular disease. Plaque was detected in 57.1% of participants, with prevalence increasing with age. For adults under 30, about 1 in 13 showed signs, which rose to about 9 in 10 among those aged 60 to 70. These findings were published in The New England Journal of Medicine in August.
Understanding Atherosclerosis
Atherosclerosis involves the accumulation of fatty deposits, cholesterol, and other substances inside arteries. This process often progresses quietly over years, eventually leading to heart attacks or strokes. The study uncovered silent artery plaque in some healthy young adults without known cardiovascular disease.
“For decades, we estimated cardiovascular risk using factors like age, blood pressure, and cholesterol,” stated Dr. Borja Ibáñez, a cardiologist and scientific director of Spain’s National Center for Cardiovascular Research. “This study shows we can now detect the disease directly before it causes a heart attack or stroke.”
The REACT Study: Mapping Silent Artery Plaque
The findings originate from the initial phase of the ongoing international REACT study. This study maps the prevalence of silent artery plaque across adulthood. The next phase will investigate whether early detection improves heart disease prevention. Professor Henning Bundgaard, a cardiologist at Rigshospitalet in Copenhagen, emphasized, “REACT shows atherosclerosis can be detected decades before clinical symptoms appear and provides the most comprehensive atlas of disease evolution across adult life.”
Gender Differences and Risk Assessment
The study also highlighted gender differences, noting that men tend to develop plaque 5 to 10 years earlier than women. Women experience the steepest increase in plaque between ages 40 and 60. Despite commonly used cardiovascular risk scores, which only identify a small proportion of those with silent atherosclerosis, many cases likely remain undetected using traditional risk assessments alone.
Experts believe portable ultrasound could eventually play a role in identifying hidden plaque earlier. However, more clinical trials are necessary.
Prioritizing Heart Health
The results should prompt individuals to prioritize heart health without causing panic. Dr. Sirisha Vadali, a cardiologist at HonorHealth Women’s Heart Health in Arizona, advised, “Finding plaque doesn’t mean a heart attack is imminent, but it provides an opportunity to address risk factors. We should focus on heart health before symptoms manifest.” She added, “Feeling healthy doesn’t mean your arteries are free of plaque.”
Vadali emphasized that the study does not advocate universal artery screening for those under 30. Testing should be based on individual risk factors. She advised maintaining healthy lifestyle habits, such as avoiding tobacco, staying active, and consuming a diet rich in vegetables, fruits, beans, whole grains, nuts, and fish while limiting saturated fat and excess sodium to support heart health.
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