A groundbreaking study published in the Journal of the American College of Cardiology has unveiled shocking evidence connecting subclinical atherosclerosis to increased risks of all-cause mortality in individuals without any prior signs of clinical cardiovascular disease (CVD). This revelation is particularly alarming, as it underscores the silent threat posed by a condition that often goes unnoticed until it's too late.

The extensive research, involving 5,716 adults who participated in the BioIMage study between 2008 and 2009, utilized advanced imaging techniques such as vascular ultrasound (VUS) and computed tomography (CT) to assess carotid plaque burden (cPB) and coronary artery calcium (CAC) scores. These methods provide a glimpse into the state of cardiovascular health long before symptoms present themselves.

Dr. Ana García Álvarez of the Centro Nacional de Investigaciones Cardiovasculares (CNIC) explains, “Carotid plaque accumulates cholesterol, calcium, and various substances in the blood vessel wall. This buildup can significantly narrow or block the carotid arteries, decreasing blood flow to the brain and heightening the chance of a stroke.”

Atherosclerosis, the process behind this plaque formation, often develops quietly over years, sometimes even decades, before any clinical signs of CVD emerge. As global mortality due to CVD continues to be a leading concern, traditional risk factors alone may not provide enough insight into long-term individual risk.

The study aimed to shed light on how effectively quantifying atherosclerosis can help predict these risks. Led by Dr. Valentin Fuster, a prominent leader in cardiovascular research, the team sought to provide clarity on the independent predictive value of subclinical atherosclerosis, beyond standard risk factors.

Dr. Fuster noted, “The long asymptomatic phase of the disease presents a window of opportunity that has not been fully utilized, especially in younger populations.”

The participants were assessed with VUS and CAC scoring, with 732 individuals returning for a follow-up examination nearly 9 years later. Throughout a median follow-up period of 12.4 years, 901 participants—approximately 16%—passed away. Strikingly, after adjusting for common cardiovascular risk factors, baseline cPB and CAC scores were found to be significantly linked to all-cause mortality.

The results revealed that for every 10 mm³ increase in cPB, there was a correlated rise in mortality risk, triggering alarms for those with plaque progression (P = .01). The data even suggested that cPB might serve as a more robust indicator of mortality risk than CAC scores.

Dr. Borja Ibáñez, a leading cardiologist at CNIC, emphasized, “VUS is a noninvasive and low-cost test that offers valuable prognostic insights. We can utilize this information to enhance risk stratification and tailor lifestyle recommendations for managing cardiovascular risk factors.”

As awareness grows about the irrefutable link between subclinical atherosclerosis and mortality, the medical community may need to reevaluate how we assess cardiovascular health. Do you know your carotid plaque levels? This knowledge could be a matter of life and death!

Determining your risk could be the key to a longer, healthier life. Don’t wait for symptoms—take action now!