The plaques in the arteries appear very early: how to detect them to prevent heart attack and stroke

Atherosclerosis, the accumulation of fat and cholesterol in arteries forming plaques, is not solely a disease of old age but begins very early. Studies involving nearly 17,000 adults showed that atherosclerosis was present in almost 60% of participants in a large investigation, with plaque detected in one in every 13 participants under 30 years old. The progression of this condition is silent and affects many, leading to cardiovascular disease mortality. Researchers propose that current risk assessment strategies based on estimations do not fully capture the presence of subclinical atherosclerosis. A study found differences in the rate of progression based on sex, with men showing earlier increases in the early stages and women experiencing acceleration during the menopausal transition. The findings support a shift toward personalized prevention by detecting these plaques through imaging rather than relying solely on risk factor estimation for primary cardiovascular prevention.

The narrative shifts the focus from retrospective risk estimation to prospective detection of silent pathology, suggesting that current clinical practice relies on insufficient data regarding subclinical disease. The central tension lies between the established, score-based primary prevention model and the call for early, personalized intervention based on imaging. This creates a systemic blind spot where individuals are assessed based on *estimated* risk rather than *actual* arterial load. The shift in approach implies that inertia—the tendency to wait until symptoms manifest or rely on imperfect metrics—is itself a critical barrier to cardiovascular health. Furthermore, the discussion about low-risk individuals having substantial plaque underscores the failure of generalized risk stratification when confronted with biological reality, especially considering unmeasured factors like stress and environmental pollution that formal scores omit. The call for personalized prevention based on sex and life stage acknowledges that biological timelines are not uniform, pushing for a framework where intervention timing is dictated by physiological onset rather than standardized age brackets alone.