A major new international study reveals that silent atherosclerosis—the hardening of the arteries from fatty plaque buildup—begins decades earlier than previously understood. According to the research, about 1 in 13 adults aged 18 to 29 already carries hidden artery plaque despite having no known cardiovascular disease, while 57.1% of healthy adults overall show signs of the condition.
Imaging 16,800 Healthy Adults Across Denmark and Spain
Researchers from Denmark and Spain examined more than 16,800 adults between the ages of 18 and 70 with no known history of cardiovascular disease. The ongoing international REACT study utilized advanced imaging technology, including three-dimensional ultrasound scans of the carotid arteries in the neck and femoral arteries in the groin, alongside coronary computed tomography (CT) angiography to map the arteries feeding the heart muscle.
The results demonstrate that plaque accumulation increases exponentially with age rather than growing at a slow, steady rate. While only about 1 in 13 adults under 30 shows detectable plaque, roughly 9 in 10 adults ages 60 to 70 carry the disease, as reported by foxnews.com. Furthermore, the data indicates that looking solely at heart scans misses early disease, because plaque in younger individuals typically appears in peripheral vessels like the neck or legs rather than the coronary arteries.
Diverging Timelines Between Men and Women
The study highlights distinct chronological differences in how plaque develops across sexes. Men tend to develop arterial plaque five to 10 years earlier than women. By age 50, about half of all men in the study had silent plaque, compared to approximately 30 percent of women at the same age.
However, women experience their steepest increase in plaque accumulation between the ages of 40 and 60, a timeframe that typically coincides with menopause and falling estrogen levels. By the time participants reached their 60s and 70s, the gender gap narrowed significantly, with nearly identical high prevalence rates across both groups.
Why Traditional Risk Scores Miss Early Cases
Current preventive cardiology relies heavily on traditional risk estimation tools that factor in age, blood pressure, cholesterol levels, smoking habits, and gender. According to Professor Henning Bundgaard, professor of cardiology at Rigshospitalet in Copenhagen, these standard assessment tools only estimate risk based on predictions rather than confirming whether the disease is already present inside the body.
The REACT findings show that conventional risk scores miss a substantial portion of individuals who already harbor silent atherosclerosis. Dr. Borja Ibáñez, a cardiologist and scientific director of Spain’s National Center for Cardiovascular Research (CNIC), noted in a statement that the imaging data allows clinicians to detect the disease directly before a heart attack or stroke occurs.
Evaluating the Next Phase of Prevention Trials
While the findings provide a comprehensive atlas of atherosclerosis across adult life, experts emphasize that identifying plaque does not automatically guarantee that universal screening will prevent future cardiac events. Dr. Sirisha Vadali, a cardiologist at HonorHealth Women’s Heart Health in Arizona who was not involved in the research, told Fox News Digital that discovering plaque offers an opportunity to address patient risk factors early, but cautioned that routine screening should not automatically apply to every young adult.
In the next phase of the REACT project, researchers will test whether earlier detection through portable ultrasound and other imaging tools can actively improve heart disease prevention outcomes in clinical trials. Until those results are available, experts recommend focusing on foundational heart health habits, including avoiding tobacco, maintaining regular physical activity, and eating a nutritious diet rich in vegetables, fruits, beans, whole grains, nuts, and fish while limiting saturated fats and excess sodium.
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