Scientists have linked calcium in the blood vessels of young people with the risk of early death

Atherosclerosis can develop over the years without causing noticeable symptoms. Therefore, changes in the arteries are sometimes found in people who consider themselves healthy and are unaware of cardiovascular problems. A new study has shown that even at the age of 30-45 years, pronounced calcium deposits in the heart vessels may be associated with an increased risk of death in subsequent decades. About why such changes are considered an alarming signal and what long—term consequences scientists have identified - in the material of Izvestia.

How early atherosclerosis is detected

Calcium deposits in the coronary arteries can be a sign of atherosclerosis, including at a stage when the disease does not yet cause noticeable symptoms. Their number is assessed using computed tomography: the study makes it possible to detect and measure calcium in atherosclerotic plaques. The higher the indicator, the more pronounced the vascular lesion may be.

The research team examined the relationship between the amount of calcium in the coronary arteries and the long-term risk of death in people aged 30 to 45 years. The results are published in the journal JAMA Cardiology.

The analysis included data from 12,847 people. The average age of the participants was 40.5 years. Of the total, 77.2% were men. This was a cohort of people who were prescribed CT scans to assess calcium deposits based on clinical indications, rather than a random sample of the population. The participants were divided into groups depending on the level of calcium in the coronary arteries. The researchers paid special attention to people whose age exceeded the 90th percentile, taking into account age, gender and racial characteristics.

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What risks did the surveillance reveal?

The median follow-up period was 22.6 years. During this time, 624 participants died, including 149 people from cardiovascular diseases and 81 from coronary heart disease.

The most pronounced association with the risk of death was found in people whose calcium index exceeded the 90th percentile. Compared with participants who had no calcium deposits, the adjusted risk ratio for death from all causes was 1.87. For cardiovascular diseases, this indicator reached 2.60, and for coronary heart disease — 3.71.

This dependence persisted even after the researchers took into account age, gender, and traditional cardiovascular risk factors. Thus, a high calcium score was associated with an unfavorable prognosis, even taking into account other health characteristics of the participants.

What did the calculations for 30 years show?

The researchers also calculated the model probability of death within 30 years for people with different levels of calcium in the coronary arteries. In the group with a score above the 90th percentile, the risk of death from all causes was 12.9%, while among participants without deposits it was 7.5%.

For mortality from cardiovascular diseases, the estimated figures reached 4.5% versus 1.5%. The probability of death from coronary heart disease was 3% in the group with the highest levels of calcium and 0.6% among those who did not have it.

These values do not represent the proportion of participants who actually died in 30 years, but the probabilities calculated by the researchers. To evaluate them, the scientists used statistical methods that combined survival analysis and modeling. Therefore, the indicators reflect the estimated long-term difference between the groups, and not just the results of direct observation.

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What is important to consider

The calcium index does not reflect all changes in blood vessels and does not allow us to evaluate every characteristic of atherosclerotic plaque. The absence of calcium during the examination also does not mean that there are no atherosclerotic changes at all. Therefore, the result of such a study is considered as one of the indicators of cardiovascular risk, and not as an independent diagnosis.

The data obtained, according to the authors, can help improve approaches to assessing cardiovascular risk and disease prevention. In particular, the detection of pronounced calcium deposits in young people may indicate the need for closer attention to prevention.

However, the work has limitations. It includes people who were prescribed CT scans for clinical reasons, rather than a random sample of the population. In addition, almost four-fifths of the participants were men. Therefore, the results cannot be automatically transferred to all young people. The study found a statistical link between calcium levels and mortality, but it does not prove that the deposits themselves are the direct cause of death.