A new study that appears in the Journal of the American College of Cardiology has found that atherosclerosis — the process of fatty plaques building up in the arteries that lead to the heart and the leading cause of coronary heart disease — rapidly increases in people between the ages of 40 and 50.
The researchers conducted the study using imaging techniques, demonstrating that ultrasound imaging can be simpler and more efficient than other techniques.
According to the Centers for Disease Control and Prevention (CDC), atherosclerosis occurs when deposits of cholesterol, as well as other substances, build up in the walls of the arteries, causing these vessels to narrow.
This narrowing can reduce the flow of blood or, at its most severe, completely block it. When this happens in the arteries that supply blood to the heart, it is called coronary heart disease. The symptoms can include chest pain, weakness, dizziness, pain in the arms, and shortness of breath.
Eventually, this can lead to the weakening of a person’s heart muscle, which can result in a heart attack.
Risk factors for coronary heart disease include smoking, diabetes, having overweight or obesity, eating an unhealthful diet, and having a family member who has heart disease.
In the new study, the researchers analyzed data that covered 10 years and came from 4,200 middle-aged men and women who were in good health.
They found that, contrary to what experts previously thought, atherosclerosis can happen rapidly between the ages of 40 and 50, even in people who otherwise appear healthy.
According to Dr. Borja Ibañez, Clinical Research Director of the Centro Nacional de Investigaciones Cardiovasculares (CNIC) in Madrid, Spain: “This study is the first to analyze the progression of atherosclerosis at frequent intervals. The previous view was that the disease progressed very slowly throughout life. However, the new results show that the disease progressed very rapidly in 40% of the individuals analyzed.”
“Future data from [this] study will show whether this progression is associated with subsequent cardiovascular events. Until now, the speed of atherosclerosis progression has not been a factor in assessing individual risk.”
The research also found evidence to confirm the classic risk factors for atherosclerosis.
As well as discovering that atherosclerosis can occur rapidly between the ages of 40 and 50, the researchers also used ultrasound imaging techniques to determine the buildup of fatty plaques in the study participants’ arteries.
According to Dr. Valentín Fuster, Director of the CNIC and the lead investigator of the study, this method allowed the team “to identify the progression of the disease earlier than is possible with classical markers, such as the presence of coronary calcium detected by computed tomography (CT), thus allowing us to identify individuals at higher risk who could benefit from early intervention.”
CT imaging requires exposure to a low dose of radiation, which ultrasound imaging avoids. In the present study, the authors were able to compare both techniques directly to determine their relative merits.
According to Dr. Beatriz López-Melgar, lead author of the study, “The results show that ultrasound of the peripheral arteries is a more efficient method for detecting atherosclerosis progression than the study of coronary calcium by CT.”
Doctors often only detect atherosclerosis after a person has had a heart attack or stroke. At this late stage, interventions to reduce atherosclerosis have limited effectiveness.
Being able to detect atherosclerosis easily and knowing to look for it between the ages of 40 and 50 could, therefore, help stop the disease progressing to a point where it becomes dangerous.
For Dr. López-Melgar, “The key finding of the study is that over a short follow-up of just 3 years, 40% of individuals aged between 40 and 50 years showed major progression of atherosclerosis in distinct locations, including the carotid, femoral, and coronary arteries.”
“This rapid disease progression could make these individuals more vulnerable to developing symptoms or having clinical events, such as a heart attack or stroke.”