Artery Scans Reveal Early Plaque in Many Young Adults
An international study of 16,808 adults used advanced artery scans and found silent atherosclerosis in 57.1% of people with no known cardiovascular disease. Plaque was detected in about one in 13 adults before age 30, indicating the condition can begin much earlier than symptoms suggest. The findings were presented at ESC Congress 2026 and published in The New England Journal of Medicine.
The REACT project is tracking hidden artery disease across adulthood. Its first phase, REACT-DETECT, started in 2024; a possible second phase, REACT-PROTECT, is planned for 2027–2032 if funding is approved. The effort involves hospitals in Denmark and Spain and received up to EUR 23 million from the Novo Nordisk Foundation for phase one.
Cardiovascular disease causes nearly 20 million deaths annually, and atherosclerosis underlies most. Standard prevention often estimates future risk from age, cholesterol, blood pressure, and smoking, but those scores do not directly reveal existing plaque. REACT’s leaders propose imaging to detect silent atherosclerosis before symptoms, then guiding preventive care based on actual disease presence.
If imaging detects silent plaque earlier, more younger adults may be identified as candidates for lifestyle or medication discussions, potentially shifting prevention from risk prediction to disease confirmation. This could affect screening workloads, healthcare costs, and patient anxiety, while offering chances to delay heart attacks and strokes. Benefits may depend on whether early findings lead to effective interventions and whether health systems can support broad scanning.