Silent Heart Disease Threat Found in Young Adults

Artery-clogging plaque, a precursor to heart attacks and strokes, is present in a significant number of young adults who have no known cardiovascular disease, according to a large international study. The research found that approximately 1 in 13 adults between the ages of 18 and 29 had silent atherosclerosis, the hardening and narrowing of arteries due to plaque buildup.

Overall, the study, which examined over 16,800 adults aged 18 to 70 with no prior cardiovascular conditions, revealed that more than half of all participants showed signs of plaque in their arteries. The prevalence of this silent disease increased with age, rising from about 7.7% in those under 30 to roughly 90% in individuals between 60 and 70 years old.

Atherosclerosis develops over many years as fatty deposits, cholesterol, and other substances accumulate within the artery walls. This process often occurs without noticeable symptoms until it leads to a critical event like a heart attack or stroke.

"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."

The findings are part of the initial phase of the REACT study, designed to map the prevalence of silent artery plaque across different age groups. A subsequent phase will investigate whether early detection can improve the prevention of heart disease.

"Until now, preventive decisions have been based on an estimate of risk, but we did not know whether the disease was already present," stated Henning Bundgaard, 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 noted gender-based differences, with men tending to develop plaque 5 to 10 years earlier than women. For women, the most significant increase in plaque buildup occurred between the ages of 40 and 60.

Furthermore, the research indicated that traditional cardiovascular risk scores identified only a small fraction of individuals with silent atherosclerosis, suggesting that current assessment methods may miss a notable number of cases.

While portable ultrasound technology could potentially aid in earlier detection, researchers emphasize that further clinical trials are necessary. Experts advise individuals to take heart health seriously but avoid undue alarm, as the presence of plaque does not automatically predict an imminent heart attack. Instead, it presents an opportunity to manage risk factors.

"We shouldn’t wait for symptoms to start paying attention to heart health," said Dr. Sirisha Vadali, a cardiologist not involved in the study. "Feeling healthy doesn’t necessarily mean your arteries are free of plaque."

Dr. Vadali recommended maintaining a heart-healthy lifestyle, including avoiding tobacco, regular physical activity, and a diet rich in fruits, vegetables, whole grains, and lean proteins, while limiting saturated fats and excess sodium.