Silent artery disease is usually associated with aging, but a large European study found signs of atherosclerosis in some adults before age 30.
Researchers studied 16,808 adults in Denmark and Spain who had no known atherosclerotic cardiovascular disease. Among participants ages 18 to 29, signs of atherosclerosis appeared in 8.7 percent of men and 6.7 percent of women.
That works out to roughly one in 13 people in the youngest age group.
What makes the finding especially striking is where the plaque appeared: researchers were looking beyond the heart and across several parts of the arterial system.
The Disease Was Not Limited to the Arteries Around the Heart
Researchers examined the neck, legs, and heart, giving them a broader picture of how atherosclerosis can begin early.
The team looked at three major arterial territories: the carotid arteries in the neck, the femoral arteries in the legs, and the coronary arteries that supply the heart.
They used three-dimensional vascular ultrasound for the carotid and femoral arteries and coronary CT angiography for the heart.
Among younger adults, the disease was most often peripheral and limited to one vascular territory.
That detail matters because atherosclerosis can exist outside the coronary arteries long before it becomes part of a familiar heart disease story.
The study also found that isolated coronary atherosclerosis was relatively uncommon across the age groups examined, appearing in no more than 9.3 percent of men and 5.0 percent of women.
More Than Half of the Full Study Group Had Detectable Plaque
Across all ages, 57.1 percent of participants had signs of silent atherosclerosis.
Participants ranged from 18 to 70 years old, and disease prevalence increased with age.
The pattern clearly showed that atherosclerosis was not confined to later life. It was already detectable in some people decades earlier.
The study was published online in The New England Journal of Medicine on August 29, 2026, and presented during a Hot Line session at the European Society of Cardiology Congress in Munich.
Enrollment for the first phase ran from November 2024 through June 2026.
Researchers Are Looking Beyond Future Risk
The work reflects a shift from estimating who may develop disease to seeing whether disease is already present.
Dr. Borja Ibáñez described that idea directly in material released by Spain’s National Center for Cardiovascular Research, known as CNIC.
“We can now go one step further and detect the disease directly,” he said.
Professor Henning Bundgaard said atherosclerosis can be “detected decades before clinical manifestations appear.”
The significance is not that routine imaging has suddenly become the answer for everyone. The study shows that silent disease can be found early, sometimes much earlier than people may expect.
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What happens after that discovery is a separate question.
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The Next Phase Will Test Whether Earlier Detection Changes Outcomes
Finding plaque is one thing. Proving that acting on it earlier improves health is another.
Researchers have described a proposed second phase, REACT PROTECT, that would examine whether imaging-guided prevention can slow atherosclerosis or reduce cardiovascular events.
That future work will address something the current study cannot settle on its own.
The present findings show how common silent atherosclerosis was in this group and where it appeared. They do not prove that widespread imaging of young adults would prevent heart attacks, strokes, or deaths.
These Numbers Are Not a U.S. Prevalence Estimate
The study involved adults in Denmark and Spain, so its percentages should not be treated as proven rates for Americans.
The findings still matter to U.S. readers because they show how early silent atherosclerosis can appear.
But the exact numbers apply to the population studied.
There is also a difference between having no known atherosclerotic cardiovascular disease and having no cardiovascular risk factors at all.
The research did not determine what caused plaque in each participant, and it did not establish that every person with detectable plaque was on the verge of a cardiovascular event.
The Real Story Is How Early the Process Can Begin
Atherosclerosis did not suddenly appear at middle age in this study. In some people, signs of it were already present years earlier.
That may be the most useful way to read the findings.
The attention-grabbing number is the 13 figure among adults under 30. But the deeper point is that artery disease can begin quietly, in more than one part of the body, long before it becomes a diagnosis people recognize.
The next chapter is not simply about finding more plaque. It is about learning when that knowledge is useful enough to change what happens next.
What should early prevention look like if signs of artery disease can already appear before age 30?
