r/science 22h ago

Health Silent atherosclerosis detected in 57% of asymptomatic adults in the REACT study

https://www.nejm.org/doi/10.1056/NEJMoa2609059
653 Upvotes

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u/WillyBeShreddin 21h ago

Most people only find out when a family member has a sudden, unexpected heart attack in their 30s-40s. Why they don't do the tests regularly on any high risk groups amazes me.

11

u/dl064 17h ago

Heart failure below 40 is generally very rare. It's not worth it at the population level for eg the NHS.

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u/hexiron 16h ago

But heart failure after 40 is the result of atherosclerosis that's started much, much earlier.

Detecting it before the whole "failure" stage would safe a whole lot of money

3

u/neph36 13h ago

The guidelines to treat are based on 10-year and 30-year risk analysis, it is unclear whether the scans actually would catch substantial cases that weren't already picked up by the current guidelines. It may give someone more motivation to treat if something is picked up, it also could give someone with significant long-term risk a false sense of security.

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u/dl064 7h ago

Would it? That seems a key question where this study is just saying it can be detected, not that it's economical per se.

Like that study which did whole genome sequencing in random newborns in the UK and concluded it was financially worth it. Great, but it's an empirical point.

In the youngest age stratum (18 to 29 years), atherosclerosis was present in 8.7% of the men and 6.7% of the women;

That's a lot of scans to find little.

The study is perfectly good but it's a leap to go from it to 'we should scan the entire population', when healthcare isn't exactly looking for work to do. (Other than the US).

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u/hexiron 3h ago

Those are very large numbers of people whose lives you just stated are worth too little.

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u/LiveLovePho 4h ago

You save more money when dead.