A ‘silent killer’ in your blood: Cardiologist warns of a hidden health threat deadlier than cholesterol and BP |
While elevated cholesterol and high blood pressure remain well-known risk factors for heart disease, leading cardiologists are drawing attention to a different, less visible danger lurking in the bloodstream. This emerging risk does not receive the same level of public awareness or screening as cholesterol or hypertension. Experts warn that it may silently accelerate cardiovascular damage and exacerbate heart events in people who otherwise manage traditional risk factors. As heart disease continues to be a leading global cause of death, understanding this new threat is important for both patients and practitioners.
Plastic in your arteries could drastically raise heart attack and stroke risk
Cardiologist Dr Dmitry Yarano, in his Instagram post, has highlighted what he describes as a “chilling risk” within the bloodstream that could be more harmful than standard markers such as cholesterol and blood pressure. According to his post, the risk factor involves microscopic foreign particles found inside artery plaque and is associated with a significantly higher rate of cardiovascular events.In one observational study published in The New England Journal of Medicine, referenced in the physician’s commentary, patients whose arterial plaque samples had embedded particles faced up to 4.5-fold higher risk of heart attack, stroke or death within a defined follow-up period, compared to those without such particles. The investigation found plastic-based fragments such as polyethylene and polyvinyl chloride inside human atheromas (hardened arterial plaques), deep within immune cells.
New evidence shows plastic particles in arteries may accelerate heart disease
The key evidence comes from a study in which carotid artery plaques, removed during surgical interventions for high-grade stenosis, were examined under electron microscopy. Among 257 patients’ tissue samples, more than half showed plastic material lodged within the plaque. The presence of these particles correlated with higher inflammatory biomarkers, signs of oxidative stress and macrophage activation, all of which are known to accelerate plaque instability and rupture.Dr Yaranov noted that while causation is not yet proven, the strength of the association and the mechanisms observed (micro-particles embedding in vascular tissue) warrant greater attention in cardiovascular prevention.
New hidden risk in arteries may undermine traditional heart disease prevention
Traditional heart disease prevention has heavily focused on cholesterol (especially low-density lipoprotein), high blood pressure, smoking, diabetes and lifestyle factors. This emerging factor suggests that even if those are well-controlled, a hidden contributor might continue to elevate risk. The presence of microscopic foreign matter in plaques adds a layer of vascular insult through chronic inflammation, endothelial damage and heightened immune response, all of which accelerate atherosclerosis progression and increase the likelihood of acute events like heart attack and stroke.The implication is that screening only for cholesterol, hypertension, and traditional risk markers might miss a portion of at-risk individuals. It also suggests that environmental or material exposures may need to be considered in cardiovascular risk assessment.
Who might be at high risk
Because the phenomenon involves very small particles lodging in vascular tissue and provoking inflammation, potential vulnerability factors include:
- Individuals with pre-existing atherosclerosis or arterial plaque (they have a substrate for deposition)
- People exposed to high levels of microplastics or nanoplastics through the environment, water, food packaging or inhalation
- Those with high levels of vascular inflammation, oxidative stress, or immune activation
- Patients whose traditional risk factors are well-managed but who still experience cardiovascular events
Dr Yaranov emphasises that the ubiquity of plastic exposure through food, drink containers, packaging materials and airborne particles means pinpointing specific sources for each patient is difficult.
Detection and diagnostic considerations
At present, routine screening of vascular plaques for plastic particles is not part of standard cardiovascular care. The study findings emerged from surgical samples of advanced carotid disease. However, the underlying mechanisms of inflammation, oxidative stress, macrophage activation and plaque vulnerability can be assessed through blood biomarkers and imaging (e.g., CT angiogram, carotid ultrasound). Recognising this emerging risk may prompt clinicians to:
- Consider additional imaging or biomarker testing when patients have cardiovascular events despite good risk factor control
- Inquire about environmental exposure, occupational risk or lifestyle factors that may increase particle exposure
- Collaborate with specialists in environmental medicine or avoidant engineering for exposure reduction
While no formal guidelines yet exist for screening micro-particle burden, the research is pushing for updated prevention models.
Prevention and future research directions
Preventive approaches at present remain indirect, focusing on reducing exposure, managing inflammation and optimising vascular health. Key steps include:
- Minimising plastic exposure from water bottles, packaging materials, food storage and inhalation sources
- Maintaining optimal control of traditional cardiovascular risk factors (cholesterol, blood pressure, diabetes, smoking cessation)
- Incorporating anti-inflammatory lifestyle measures (regular exercise, balanced diet, weight management)
- Monitoring vascular health through imaging and markers of inflammation in high-risk patients
On the research front, several objectives are clear:
- Large-scale longitudinal studies to confirm causation and quantify risk
- Development of non-invasive tests to detect microplastic burden in vascular tissue
- Studies to explore mechanisms of particle lodging, migration, immune response and plaque destabilisation
- Public health evaluation of exposure sources and mitigation strategies
Dr Yaranov describes this as “the next frontier in heart care”.
Implications for patients and medical practice
For patients, the takeaway is that managing cholesterol and blood pressure remains essential but may not be sufficient alone. It is important to ask your doctor about potential non-traditional risks if cardiovascular issues persist despite good control of standard factors. For cardiologists and primary care physicians, this development may prompt integration of environmental exposure assessments, broader vascular imaging use and consideration of novel risk markers in comprehensive cardiovascular risk stratification.The medical community may need to update prevention frameworks to move beyond “lipids + pressure” models and include additional vascular insults. Policymakers could also be engaged in reducing plastic pollution and exposure as part of public cardiovascular health strategy.
