REACT Study Finds Silent Atherosclerosis in More Than Half of Healthy Adults

Overview

• The REACT Phase 1 results, presented at ESC Congress and published in The New England Journal of Medicine on August 29, 2026, found 57.1% of 16,808 apparently healthy adults aged 18–70 had atherosclerotic plaques.
• Plaque was detectable from early adulthood with about 1 in 13 people aged 18–29 affected and prevalence rising to roughly 9 in 10 by ages 60–70, with men developing disease about five to ten years earlier than women.
• Investigators used three‑dimensional ultrasound of the carotid and femoral arteries plus coronary CT to map plaque and found most people with coronary disease also had carotid or femoral plaque.
• Standard risk scores such as SCORE2 classified only a small share of people who already had plaques as high risk, a gap that study authors say supports testing an imaging‑guided, precision prevention approach.
• The study was funded by the Novo Nordisk Foundation for Phase 1 and researchers plan a Phase 2 randomized trial (REACT‑PROTECT) to test whether screening and targeted treatment slow progression and cut events, but that trial depends on further funding and wider validation including work in India, Singapore, Tanzania and Mexico.