Silent Heart Threat Detected in Young Adults, Study Finds
Artery-clogging plaque is present in about 1 in 13 adults under 30, even without known cardiovascular disease, according to new research.
A significant number of young adults, even those with no known cardiovascular issues, are exhibiting signs of atherosclerosis, the hardening of the arteries due to plaque buildup. A major international study found that approximately 1 in 13 adults aged 18 to 29 already had silent atherosclerosis, and over half of all healthy adults in the study displayed signs of plaque in their arteries.
The research, published in The New England Journal of Medicine, involved examining over 16,800 adults between the ages of 18 and 70 who had no prior diagnosis of cardiovascular disease. Using advanced imaging techniques, researchers discovered plaque in 57.1% of participants. The prevalence of plaque increased with age, rising from about 8% in adults under 30 to approximately 90% in those aged 60 to 70.
Atherosclerosis develops when fatty deposits, cholesterol, and other substances accumulate inside arteries. This process can occur silently over many years before leading to serious events such as heart attacks or strokes.
"For decades, we have estimated cardiovascular risk using factors such as age, blood pressure and cholesterol," said Dr. Borja Ibáñez, a cardiologist and scientific director of Spain's National Center for Cardiovascular Research (CNIC). "This study shows that we can now go one step further and detect the disease directly before it causes a heart attack or stroke."
These findings are part of the initial phase of the ongoing REACT study, which aims to map the prevalence of silent artery plaque throughout adulthood. Future phases will investigate whether early detection can improve the effectiveness of heart disease prevention strategies.
"Until now, preventive decisions have been based on an estimate of risk, but we did not know whether the disease was already present," stated Professor Henning Bundgaard, a professor of cardiology at Rigshospitalet in Copenhagen. "REACT shows that atherosclerosis can be detected decades before clinical manifestations appear and provides the most comprehensive atlas of the evolution of the disease across adult life."
The study also indicated that men tend to develop plaque five to 10 years earlier than women. Women experienced their most rapid increase in plaque buildup between the ages of 40 and 60.
Furthermore, the research revealed that commonly employed cardiovascular risk scores were insufficient in identifying a substantial portion of individuals who already had silent atherosclerosis, suggesting that traditional risk assessments may miss some cases.
While researchers are exploring the potential of portable ultrasound for earlier plaque detection, they emphasize the need for further clinical trials. Experts advise that the study's findings should underscore the importance of heart health without causing undue alarm. The presence of plaque does not automatically signify an imminent heart attack, but it presents an opportunity to address risk factors.
Dr. Sirisha Vadali, a cardiologist at HonorHealth Women’s Heart Health, who was not involved in the research, noted that "Feeling healthy doesn't necessarily mean your arteries are free of plaque." She cautioned that the study alone does not confirm that universal screening would directly prevent heart attacks or strokes. Decisions regarding additional testing should be individualized based on a person's specific risk factors. Vadali recommended maintaining a heart-healthy lifestyle, including avoiding tobacco, staying physically active, and consuming a diet rich in vegetables, fruits, beans, whole grains, nuts, and fish, while limiting saturated fats and excessive sodium.