Scientists talked about the spread of latent atherosclerosis among adults

Atherosclerosis can develop in blood vessels long before the first symptoms appear. A person does not feel plaques gradually forming on the walls of the arteries, but over time these changes can lead to serious circulatory disorders. New data shows that signs of the disease are found even in young adults who consider themselves healthy. The age at which vascular changes begin and how they differ in men and women is described in the Izvestia article.

Plaques before the first symptoms

An international team of researchers from Denmark and Spain studied the prevalence of latent atherosclerosis in 16,808 people aged 18 to 70 years. The participants had no previously diagnosed atherosclerotic cardiovascular diseases. The results of the work are published in The New England Journal of Medicine (NJEM).

Signs of atherosclerosis were found in 57.1% of the participants. The average age of the volunteers was 45 years, and women represented 51.4% of the sample. The study became part of an international project aimed at tracing how the disease forms and spreads through the arteries throughout adulthood.

Atherosclerosis develops when cholesterol and other substances accumulate in the inner lining of the arteries, forming plaques. They can gradually narrow the lumen of blood vessels and obstruct blood flow. At the same time, the process can go unnoticed for a long time: the absence of complaints does not mean that there are no changes in the arteries.

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The first changes are already under 30 years old

In the youngest age group, from 18 to 29 years old, atherosclerosis was detected in 8.7% of men and 6.7% of women. In other words, about one in 13 participants under the age of 30 showed signs of the disease.

With age, the prevalence of changes increased. Among people aged 60-70, signs of atherosclerosis were found in more than 90% of the participants. At the same time, the nature of vascular lesions was also changing: in young people, plaques were more often found in one area, whereas in older age groups, simultaneous lesions of several arterial basins were increasingly common.

The authors also found that men had atherosclerosis earlier. In women, the prevalence of the disease increased later, but in middle age the increase was more pronounced. Thus, the age dynamics of the two sexes differed, although in the older groups, signs of atherosclerosis were common in both men and women.

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Not just the coronary arteries

To search for plaques, the researchers examined the carotid and femoral arteries using three—dimensional ultrasound, and the coronary arteries using computed tomography with angiography. This approach made it possible to assess the condition of blood vessels in several parts of the body at once.

In younger participants, the changes were more often limited to peripheral arteries and one vascular region. With age, not only the volume of plaques increased, but also the likelihood that they would be found in several groups of arteries at once. At the same time, isolated damage to the coronary arteries alone remained relatively rare in all age categories.: It was detected in no more than 9.3% of men and 5% of women.

The researchers emphasize that assessing the condition of blood vessels in different areas of the body provides a more complete picture of the spread of atherosclerosis. Checking only the coronary arteries may not show all the changes that are already occurring in the vascular system.

Why the usual risk assessment is not enough

The authors note that traditional tools for assessing cardiovascular risk do not always allow us to determine whether a person has already formed atherosclerotic plaques. In particular, assessment scales such as the SCORE2 system classified only a small part of the participants with atherosclerosis as high-risk. This discrepancy was especially noticeable among young people.

It is not yet claimed that vascular imaging is necessary for every person or that this approach has already proven its ability to prevent heart attacks and strokes. To test this idea, the next stage of the project is planned: scientists intend to evaluate whether a prevention strategy based on arterial imaging results helps slow down the development of atherosclerosis and reduce the risk of cardiovascular events.