Copenhagen, Sep.1 (SANA) An international study has found that atherosclerosis can develop silently from early adulthood, even in people with no known cardiovascular disease, highlighting the importance of prevention and long-term monitoring of cardiovascular risk factors.
The study, published in the New England Journal of Medicine, examined 16,808 adults aged 18 to 70 in Denmark and Spain as part of the REACT initiative. The research was led by Professor Henning Bundgaard of Rigshospitalet–Copenhagen University Hospital in Denmark.
Researchers used three-dimensional vascular ultrasound to examine the carotid and femoral arteries, together with computed tomography angiography to assess the coronary arteries.
Signs of silent atherosclerosis were detected in 57.1 percent of all participants. The prevalence, however, was much lower among young adults. Among participants aged 18 to 29, it was detected in 8.7 percent of men and 6.7 percent of women. The prevalence increased substantially with age, reaching approximately 90 percent among people aged 60 to 70.
The researchers found that atherosclerosis generally appeared earlier in men, while women experienced a later but more rapid increase in the burden of the disease during midlife.
Atherosclerosis occurs when fatty deposits and other substances accumulate in the walls of arteries, forming plaques that can gradually restrict blood flow or become unstable and contribute to heart attacks and strokes. The condition can progress for years without causing noticeable symptoms.
The findings indicate that conventional cardiovascular risk assessment—which commonly takes into account factors such as age, sex, smoking, blood pressure and cholesterol—may not fully reflect the presence of already established arterial disease in some individuals.
The researchers said that direct imaging of the arteries could potentially contribute to future strategies for earlier cardiovascular prevention. However, they stressed that further studies are needed to determine whether identifying silent atherosclerosis through imaging and subsequently treating it leads to fewer heart attacks, strokes and other cardiovascular events.
The study does not therefore support routine vascular imaging for all healthy young adults at present. Instead, it provides evidence that atherosclerotic disease can begin decades before clinical cardiovascular disease becomes apparent and underscores the importance of addressing modifiable risk factors from an early age.
The research was published under the title “Prevalence of Silent Atherosclerosis across Adult Life” in the New England Journal of Medicine.
F.J.
