In a new study from the University of Gothenburg, researchers found more than 40% of adults ages 50 to 64 years in Sweden without known heart disease were found to have some degree of atherosclerosis.
Atherosclerosis, or the buildup of fatty deposits in blood vessels that supply blood to the heart, is a major cause of heart attacks.
A widely used approach to screen people who are at risk for heart disease but who do not yet have symptoms is cardiac computed tomography, commonly known as a cardiac CT scan, for coronary artery calcification (CAC) scoring.
A CAC score of 400 or higher is associated with a high risk for having a heart attack, stroke or dying from either one within the next 10 years. However, CAC scoring can miss a percentage of people who are at risk for heart attack even though they have a zero CAC score.
In the study, the team recruited participants aged 50 – 64 years old from the Swedish census register from 2013 to 2018. They report on data from 25,182 participants with no history of a prior heart attack or cardiac intervention.
These people underwent both CAC scans and coronary computed tomography angiography (CCTA) scans. CCTA is a radiologic technique that gives a very detailed image of the inside of the arteries that supply the heart with blood.
They found CCTA detected some degree of atherosclerosis in more than 42% of the study participants.
CCTA found that in 5.2% of those with atherosclerosis, the build-up obstructed blood flow through at least one coronary artery (out of three) by 50% or more.
In nearly 2% of those found to have artery build-up, the atherosclerosis was even more severe. Blood flow was obstructed to the main artery that supplies blood to large portions of the heart, and in some cases, all three coronary arteries were obstructed.
Atherosclerosis started an average of 10 years later in women compared to men. It was 1.8 times more common in people ages 60-64 vs. those ages 50-54.
Of those with a CAC score of more than 400, nearly half had a significant blockage, where more than 50% of the blood flow was obstructed in one of the coronary arteries.
The team says many people without heart disease can have atherosclerosis in their coronary arteries.
In addition, many adults can have one or more non-calcified plaques. Non-calcified atherosclerosis is believed to be more prone to cause heart attacks compared with calcified atherosclerosis.
It is important to know that silent coronary atherosclerosis is common among middle-aged adults, and it increases sharply with sex, age and risk factors.
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The study is published in the journal Circulation. One author of the study is Göran Bergström, M.D., Ph.D.
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