- A new study finds that many adults in the U.S. may have early signs of heart disease even if they don’t have any symptoms.
- Researchers found nearly half of adults in a study had signs of coronary heart disease or coronary atherosclerosis.
- Obstructive coronary atherosclerosis is associated with a more than 8-fold elevated risk for myocardial infarction, colloquially known as heart attack.
New research published today suggests that heart disease may develop at an early age and remain latent for many years.
A study of more than 9,000 persons in Copenhagen, Denmark published today in Annals of Internal Medicine, looked at people over 40 and their risk for heart disease.
They found a significant number had not been diagnosed with heart disease, but did have subclinical obstructive coronary atherosclerosis, a type of heart disease without symptoms but which is associated with a more than 8-fold elevated risk for myocardial infarction, colloquially known as heart attack.
Subclinical coronary atherosclerosis, is more commonly known as coronary heart disease or ischemic heart disease. When it is defined as subclinical it means there are not associated symptoms.
The disease is caused by a build-up of plaque in the walls of the arteries that supply blood to the heart, according to the
This build-up of plaque can lead to a heart attack.
The study’s founders say this study provides a new and significant way to observe the natural history of coronary artery disease.
Lead researcher Dr. Klaus Fuglsang Kofoed, PhD, DmSc, is a clinical associate professor in the Department of Cardiology, The Heart Center at the University of Copenhagen.
He told Healthline that the study emphasizes the importance of closely monitoring heart issues and early detection when possible.
“This study is one of the first of this type. We’re very optimistic about what we are doing. We have seen success with lung cancer and cancer screening. We hope to pull more people who are already getting a CT scan to also include screening for cardiovascular disease,” said Kofoed.
An accompanying editorial by authors from the BHF Centre for Cardiovascular Science at the University of Edinburgh notes that this research provides an opportunity to study the current history of coronary artery disease in the absence of intervention, where neither patient nor clinician is aware of scan findings.
In the study, researchers followed 9,533 asymptomatic persons aged 40 years or older without known cardiovascular disease to define characteristics of subclinical coronary atherosclerosis associated with the development of myocardial infarction.
Participants were assessed using computed tomography angiography (CTA) to diagnose obstructive coronary atherosclerosis.
The authors found that 54% of persons had no subclinical coronary atherosclerosis.
They found that 46% of persons were diagnosed with subclinical coronary atherosclerosis.
This included 36% with nonobstructive disease and 10% with obstructive disease.
For more than 50 years, the study’s authors say, obstructive coronary artery disease has been considered a key feature of elevated risk.
But in past decades, the extent of atherosclerosis as well as specific morphologic features of the atherosclerotic plaque have become better understood as important risk factors.
Heart issues may evolve at an early age, many years before clinical disease develops, Kofoed explained.
Kofoed said early detection should be a key part of treatment of cardiac issues, similar to how screenings and early detection are a hallmark of cancer treatment.
“I must say that to some extent this is similar to cancer. There are efforts to improve our early detection in cardio, as well, and one of them is to get DNA from the blood. Liquid biopsy is still tricky as far as early detection of heart disease. But we think it has potential,” Kofoed said
Dr. Elizabeth Kordas, is a preventative cardiologist and founder of Step One Foods, a food company she created for her cardio patients.
She was not a part of this study.
She told Healthline that most of what is in this study is not new but is important.
“My overall take on this study is that it confirms what we already know. This process starts early and it can make itself known in many ways,” she said.
“But I would say that this study is valuable. It makes all the sense in the world to start prevention early. Don’t wait.”
Kordas, who was trained at Johns Hopkins and the Mayo Clinic, said that getting regular assessments of your risk should start in childhood with information about such things as blood pressure and cholesterol.
“At age 10 and age 20 people should be checked. Just keep checking these risk factors and gain more control over all of this. Look at the food you are eating, smoking, exercise, all of that matters,” she said.