Feeling healthy does not always mean that everything happening inside the body is easy to detect.
New research involving more than 16,000 adults has found that signs of artery plaque were present in more than half of participants who had no known cardiovascular disease. The findings offer a closer look at how changes in the arteries can develop before noticeable symptoms appear.
The study, published in the New England Journal of Medicine, included 16,808 adults between ages 18 and 70. Participants were divided into five age groups, with men and women represented in roughly equal numbers.
Researchers used several types of imaging to examine the participants arteries, including ultrasound scans of the carotid arteries in the neck and femoral arteries in the legs, along with CT imaging of the coronary arteries around the heart.
The goal was to identify plaque that had not yet produced symptoms or been diagnosed as cardiovascular disease.
More than half had detectable plaque
Overall, 57.1% of the participants had evidence of plaque in at least one artery.
The finding was notable because the participants did not have known cardiovascular disease when they entered the study. The results suggest that changes in the arteries can be present long before a person develops obvious warning signs.
Plaque consists of deposits that can build up inside artery walls. Over time, plaque can contribute to narrowing of the arteries and may increase the risk of cardiovascular complications.
The researchers found that plaque was not limited to the arteries supplying the heart. In younger participants, it was more commonly detected in the neck or leg arteries and was often found in only one area.
That detail is important because focusing exclusively on the heart’s arteries could potentially overlook early changes elsewhere in the vascular system.
The findings appeared even among younger adults
Age remained strongly associated with the amount of plaque detected in the study.
Researchers observed that plaque prevalence increased substantially as participants grew older, suggesting that the process accelerates rather than simply increasing at the same pace throughout adulthood.
At the same time, plaque was not exclusively a finding among older participants. About 9% of men between ages 18 and 29 had detectable plaque.
That does not mean that a young adult with plaque will inevitably develop cardiovascular disease. Rather, the finding indicates that changes associated with cardiovascular risk can begin earlier than many people may realize.
The researchers noted that identifying plaque at a younger age could provide an opportunity to better understand individual risk and potentially address factors that contribute to cardiovascular health.
A scan does not predict the future by itself
The presence of plaque should not automatically be interpreted as a prediction that someone will experience a heart attack or stroke.
Cardiovascular risk is influenced by numerous factors, including age, blood pressure, cholesterol levels, smoking status, diabetes, family history, diet, physical activity and other aspects of health.
The study also does not establish that routinely scanning symptom-free young adults for plaque will prevent future cardiovascular events.
More research is needed to determine whether identifying plaque before symptoms appear changes long-term outcomes and whether widespread screening would provide meaningful benefits.
Routine health checks still matter
For most people, preventive care does not necessarily begin with advanced imaging.
Regular medical visits can provide opportunities to monitor established cardiovascular risk factors, including blood pressure and cholesterol. Depending on a person’s age, medical history and individual risk profile, a healthcare professional may recommend additional testing or lifestyle changes.
Healthy eating patterns, regular physical activity, maintaining an appropriate weight and avoiding tobacco exposure are among the measures commonly associated with cardiovascular health.
The new findings reinforce the broader idea that cardiovascular changes can develop quietly. A person may feel completely well while changes are occurring inside the arteries.
What the study means for everyday health
The discovery of plaque in 57.1% of participants does not mean that more than half of all adults will eventually develop serious cardiovascular disease.
Instead, the research provides evidence that early artery changes are more common than symptoms alone would suggest.
It also highlights why age should not be the only consideration when thinking about cardiovascular health. Risk factors can accumulate over time, while early adulthood may provide an important opportunity to establish habits that support long term heart and vascular health.
For now, the researchers’ findings add to the evidence that cardiovascular disease develops over many years. Further studies will be needed to determine whether detecting plaque before symptoms appear can improve prevention and treatment.
In the meantime, routine checkups remain a practical way to keep track of measurable risk factors and discuss any concerns with a healthcare professional even when everything seems to feel fine.
