About 1 in 13 adults between the ages of 18 and 29 already have silent atherosclerosis — a buildup of artery-clogging plaque — even though they have no known cardiovascular disease, according to a major international study that examined more than 16,800 adults.
The research, published in The New England Journal of Medicine in August, found plaque in 57.1% of participants ages 18 to 70 who had no known cardiovascular disease. Prevalence rose steadily with age, from roughly 1 in 13 adults under 30 to about 9 in 10 adults ages 60 to 70.
Atherosclerosis occurs when fatty deposits, cholesterol and other substances accumulate inside arteries. The process often develops silently over many years before causing a heart attack or stroke, which is why the new findings are drawing attention from cardiologists who have long relied on risk estimates rather than direct detection of disease.
«For decades, we have estimated cardiovascular risk using factors such as age, blood pressure and cholesterol,» Dr. Borja Ibáñez, a cardiologist and scientific director of Spain's National Center for Cardiovascular Research, said in a statement. «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 results come from the first phase of the ongoing international REACT study, which is mapping how common silent artery plaque is across adulthood. In the next phase, researchers will test whether earlier detection can improve heart disease prevention.
«Until now, preventive decisions have been based on an estimate of risk, but we did not know whether the disease was already present,» said Professor 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 found that men tended to develop plaque five to 10 years earlier than women, while women experienced their steepest increase between ages 40 and 60. Commonly used cardiovascular risk scores identified only a small proportion of people who already had silent atherosclerosis, suggesting some cases may go undetected using traditional risk assessments alone.
Researchers believe portable ultrasound could eventually help identify hidden plaque earlier, but they said further clinical trials are needed. Experts caution that the findings should encourage people to take heart health seriously without causing panic.
«Finding plaque doesn't mean someone is about to have a heart attack, but finding it gives us an opportunity to address a patient's risk factors,» Dr. Sirisha Vadali, a cardiologist at HonorHealth Women's Heart Health in Arizona, told Fox News Digital. «We shouldn't wait for symptoms to start paying attention to heart health.»
Vadali, who was not involved in the research, added that «feeling healthy doesn't necessarily mean your arteries are free of plaque.» She cautioned that the study alone does not establish that screening everyone will directly prevent heart attacks or strokes.
She stressed that the findings do not mean everyone under 30 should undergo artery screening, saying decisions about additional testing should be based on a person's individual risk factors. She recommended avoiding tobacco, staying physically active and eating a diet rich in vegetables, fruits, beans, whole grains, nuts and fish while limiting saturated fat and excess sodium to help protect heart health.
The research adds to a growing body of evidence that cardiovascular disease can begin decades before symptoms appear. While the study does not yet prove that early detection changes outcomes, it provides the most detailed picture to date of how atherosclerosis develops across adult life — and raises the question of whether current prevention strategies are starting late.