Longevity & AgingWhy Some Arteries Clog Fast and Standard Risk Scores Miss It
Accelerated atherosclerosis (AA) is plaque that forms earlier and grows faster than standard risk equations such as PREVENT and SCORE2 predict. This narrative review covers conditions where AA is best established: rheumatoid arthritis, lupus, antiphospholipid syndrome, chronic kidney disease, HIV, diabetes, and psoriasis. It also covers genetic drivers, notably lipoprotein(a) and clonal hematopoiesis (CHIP), and how to detect and monitor the process. Carotid and femoral ultrasound, coronary calcium scoring, and selected CT angiography can reveal plaque directly when risk scores fall short. Treatment rests on aggressive lipid lowering, with inflammation as an emerging target. The evidence is largely observational, and several tools, such as pericoronary fat attenuation and polygenic scores, remain investigational.
