Your Artery Plaque Risk Starts Earlier Than You Think

A heart problem that sounds like a midlife worry is already underway in young adulthood. A wave of new coverage of large-scale heart research this weekend reports that artery plaque was found in volunteers as young as eighteen with no history of heart disease at all. The buildup was silent, caused no symptoms, and showed up only on medical imaging.

The work comes from the first phase of an international initiative known as REACT, with results published in the New England Journal of Medicine and presented at the European Society of Cardiology congress in 2026. Led by researchers including Borja Ibáñez of Spain's national cardiovascular research centre and Henning Bundgaard of a Copenhagen heart hospital, the team imaged sixteen thousand eight hundred eight adults aged eighteen to seventy across Denmark and Spain, none of whom had known cardiovascular disease. Their headline result: fifty-seven point one percent of participants already carried artery plaque in at least one vessel. Put plainly, artery plaque is far more common — and starts far earlier — than heart textbooks once assumed.

Artery Plaque Shows Up Long Before Symptoms

Breaking the volunteers into five age groups revealed a steady climb across adult life, according to New Scientist's coverage of the findings. Among adults aged eighteen to twenty-nine, about one in thirteen already had some degree of artery plaque. In their thirties, roughly a third of men and a fifth of women showed plaque, and the share kept rising each decade until nearly nine in ten adults aged sixty to seventy had it.

Men's plaque patterns consistently ran ahead of women's. As reported by News-Medical, the male profile looked about five to ten years older than the female profile at any given age, with women catching up most sharply between forty and sixty, around the menopause transition. Nobody in the study had been diagnosed with heart disease, which is exactly why the researchers call this "silent" buildup.

A Simple Neck Scan Could Spot Hidden Artery Plaque

One of the most practical findings concerns how the plaque was found. The team used two very different tools: CT angiography, which builds detailed three-dimensional images of the coronary arteries supplying the heart, and ultrasound of the carotid arteries in the neck and the femoral arteries in the legs. CT scans are expensive, hard to scale, and involve radiation, while ultrasound is quick, non-invasive, and increasingly portable.

The researchers discovered that coronary plaque almost always showed up alongside plaque in the neck or leg arteries. That overlap means doctors might not need the high-end heart scan to flag at-risk people — a simple ultrasound of the carotid or femoral arteries could serve as a routine check for hidden artery plaque. Ibáñez has suggested that portable ultrasound devices usable by ordinary healthcare workers could one day become the standard screening tool from early adulthood onward.

Perhaps more surprising is what the usual warning signs missed. Standard risk calculators, which estimate heart risk from age, blood pressure, cholesterol, and smoking, flagged only a small share of the people who already had plaque, especially among the youngest adults. In other words, the checklist your doctor runs through at a physical may not reflect whether artery plaque is already developing.

Why This Matters in Your Twenties

For Gen Z readers, the takeaway flips a familiar assumption. The "old person's disease" story turns out to be wrong — the process begins decades before symptoms, and plenty of it is already present in people scrolling through their twenties. The message for twenty-somethings is blunt: artery plaque does not wait for midlife. Independent expert Olli Raitakari of the University of Turku, who was not involved in the research, summed it up by calling atherosclerosis "a lifelong process, not a disease of old age."

The good news is that the same basics keep showing up as the strongest levers. People in the study with higher LDL cholesterol, higher blood pressure, or a family history of cardiovascular disease were more likely to have plaque, which points back to the fundamentals: keeping blood pressure and cholesterol in check, not smoking, and staying physically active. Read more about how early lifestyle signals shape long-term health in this look at immune aging and healthy aging, and browse more heart and wellness reporting on the health topic page.

What the Study Doesn't Prove

Doctors urging caution point out that plaque and peril are not the same thing. Raitakari notes that the presence of plaque does not necessarily predict a future heart attack or stroke, and there is currently no evidence that screening people without known health problems would actually prevent such events. A follow-up phase planned to run through 2032 is expected to test whether imaging-guided prevention genuinely changes outcomes.

There are limits to the data as well. The volunteers all came from Denmark and Spain, so it is unclear how well the pattern holds elsewhere in the world, though the research team says collaborations are underway to validate the results in more countries. The plaque detected was also mild in many younger participants. The study tells us where the disease hides and how early it starts — the next question is whether finding artery plaque earlier lets us stop it.