Atherosclerosis, long considered a disease of older adults, is increasingly being identified in younger generations. Rising rates of obesity and type 2 diabetes are accelerating the damage to arteries, causing fatty plaque deposits to form much earlier than expected. These silent changes inside blood vessels can progress unnoticed for years until they trigger serious conditions such as heart attacks, strokes, or kidney disease. Recognising the early warning signs of atherosclerosis in young adults is vital for prevention, especially in those already living with diabetes or obesity.
Understanding what is atherosclerosis and why diabetes and obesity increases the risk
Atherosclerosis is a condition in which plaque builds up inside the arteries. Plaque is made of fat, cholesterol, calcium, and other substances found in the blood. Over time, this buildup causes the arteries to narrow, harden, and lose flexibility, restricting blood flow to vital organs.The disease can affect arteries anywhere in the body, the heart, brain, kidneys, legs, or arms, and may remain silent in its early stages. However, once arteries become significantly narrowed or blocked, symptoms appear and can vary depending on the location of the blockage.
Diabetes:Persistent high blood sugar (diabetes) inflicts damage on the inner lining of blood vessels, known as the endothelium. This damage makes it easier for cholesterol and fats to cling to the artery walls, initiating plaque formation. Over time, these changes disrupt vascular function, heighten inflammation, and raise the risk of clot formation. At the molecular level, mechanisms such as oxidative stress, advanced glycation end-products (AGEs), protein kinase C activation, and endothelial dysfunction are central to this accelerated atherosclerotic process in individuals with diabetes. According to a study published in PubMed, these pathways are strongly linked to the early onset and rapid progression of atherosclerosis in people with diabetes.Obesity:Meanwhile, obesity fuels chronic, low-grade inflammation through adipose tissue acting as an endocrine organ. Fat cells release adipokines that disrupt vascular health by increasing “bad” LDL cholesterol and reducing “good” HDL cholesterol. According to a study published in AHA Journals, these inflammatory mediators impair endothelial function and promote early plaque development When both conditions coexist, as in “diabesity,” the cardiovascular risk multiplies. A study in PubMed reported, a recent prospective cohort study revealed that individuals with both diabetes and obesity had the highest risk for cardiovascular disease and subclinical atherosclerosis compared to those with either condition alone or neither Other factors such as smoking, high blood pressure, high triglyceride levels, and lack of physical activity can further accelerate this process, creating what many researchers describe as the “perfect storm” for early atherosclerosis.
Other symptoms of atherosclerosis
In its early stages, atherosclerosis may not cause noticeable signs, which makes it particularly dangerous. According to the study published in PubMed Central, the following warning symptoms can occur:1) Symptoms in the heart (Coronary Arteries)When atherosclerosis develops in the coronary arteries of the heart, it can lead to chest pain or pressure, known as angina, which often appears during physical activity or times of stress. Some individuals may also experience shortness of breath because the heart muscle is not receiving enough oxygen-rich blood. In addition, fatigue, dizziness, or an irregular heartbeat may develop, signalling that the heart is struggling to cope with reduced circulation.2 ) Symptoms in the brain (Carotid Arteries)If atherosclerosis affects the carotid arteries that supply blood to the brain, the symptoms can be sudden and alarming. These include numbness or weakness in the arms or legs, difficulty speaking, slurred speech, or confusion. Some people may notice temporary vision loss in one eye or drooping muscles on one side of the face. Such symptoms are often linked to a transient ischaemic attack (TIA), commonly known as a mini-stroke, which is a warning sign of an increased risk of a major stroke.3) Symptoms in the legs and arms (Peripheral Artery Disease)When atherosclerosis blocks or narrows the peripheral arteries of the legs and arms, individuals may develop cramping or pain while walking, known as claudication. Circulation problems can also cause numbness, weakness, or coldness in the lower legs and feet. Over time, reduced blood flow may slow toenail growth and decrease hair growth on the legs. In more advanced cases, painful sores or ulcers that fail to heal can develop, increasing the risk of serious infections.4) Symptoms in the kidneys (Renal Arteries)Atherosclerosis in the renal arteries that supply the kidneys often results in high blood pressure that is difficult to control. Swelling in the hands, feet, or around the eyes may occur due to fluid retention, while declining kidney function can lead to fatigue and other complications. If left untreated, this form of arterial disease can progress to chronic kidney disease and significantly affect overall health.Important: These symptoms may appear gradually and are often overlooked in young adults, being mistaken for stress, fatigue, or minor health issues. Ignoring them can delay diagnosis and increase the risk of severe cardiovascular events.Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making any changes to your health routine or treatment.Also read | 10 signs your back pain could actually be a kidney stone