---
title: "Modifiable risk factors linked to vulnerable coronary plaques: OCT study finds 5 drivers"
id: "medical-news-today-0-5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-to-heart-attacks"
canonical_url: "https://medichelpline.com/clinical-feed/medical-news-today-0-5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-to-heart-attacks"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "Medical News Today"
source_url: "https://www.medicalnewstoday.com/articles/5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-heart-attacks/"
published_at: "2026-07-27T15:47:43.000Z"
evidence_level: "Verified Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Modifiable risk factors linked to vulnerable coronary plaques: OCT study finds 5 drivers
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/medical-news-today-0-5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-to-heart-attacks
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** Medical News Today
- **Source URL:** [Original Journal Publication](https://www.medicalnewstoday.com/articles/5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-heart-attacks/)
- **Published At:** 2026-07-27T15:47:43.000Z
- **Evidence Rating:** Verified Feed
## Executive GIST (TL;DR)
- Researchers from Mass General Brigham Heart and Vascular Institute analyzed **optical coherence tomography (OCT)** images from 131 patients to study plaque types across the three major coronary arteries, identifying 534 plaques in total. - The study tested associations between both **modifiable risk factors** (LDL cholesterol, high blood pressure, diabetes, obesity, smoking) and non-modifiable factors (age, sex, family history) with plaque burden and vulnerability. - A higher total number of risk factors correlated with more plaques visible on OCT and specifically with more vulnerable plaque types, including **thin-cap fibroatheroma** and **lipid-rich plaques**. - Among participants with at least four modifiable risk factors, half of plaques were thin-cap fibroatheromas and 80% were lipid-rich plaques, both lesion types linked to higher risk of adverse cardiac events such as myocardial infarction. - The association with widespread vulnerable plaques was driven by the number of modifiable rather than non-modifiable risk factors; non-modifiable factors were linked more to stable plaque types. - Study authors and quoted investigators propose **inflammation** as a likely mediator connecting the five modifiable risk factors to plaque vulnerability, while non-modifiable factors may act via less inflammation-driven pathways. - The analysis used a hospital registry cohort of patients who had not received certain treatments and were eligible for OCT, so findings are applicable primarily to a similar patient population; authors call for larger, prospective studies that test whether aggressive management of modifiable risks reduces plaque vulnerability. - The investigators conclude that early, intensive, and sustained control of modifiable risk factors may help prevent future cardiac events by reducing the number and spread of rupture-prone plaques.
## Clinical Analysis & Structured Key Points
[Medical News Today](https://www.medicalnewstoday.com/) * Health Conditions Health Conditions * [Alzheimer's & Dementia](https://www.medicalnewstoday.com/alzheimers-and-dementia) * [Anxiety](https://www.medicalnewstoday.com/anxiety) * [Asthma & Allergies](https://www.medicalnewstoday.com/asthma-and-allergies) * [Atopic Dermatitis](https://www.medicalnewstoday.com/program/investigating-atopic-dermatitis) * [Breast Cancer](https://www.medicalnewstoday.com/breast-cancer) * [Cancer](https://www.medicalnewstoday.com/cancer) * [Cardiovascular Health](https://www.medicalnewstoday.com/cardiovascular-health) * [COVID-19](https://www.medicalnewstoday.com/coronavirus?correlationId=2b137d5a-dcfb-464e-9ea6-72c5a54b4e92) * [Diabetes](https://www.medicalnewstoday.com/diabetes) * [Endometriosis](https://www.medicalnewstoday.com/endometriosis) * [Environment & Sustainability](https://www.medicalnewstoday.com/environment-and-sustainability) * [Exercise & Fitness](https://www.medicalnewstoday.com/exercise-and-fitness) * [Eye Health](https://www.medicalnewstoday.com/eye-health) * [Headache & Migraine](https://www.medicalnewstoday.com/headache-and-migraine) * [Health Equity](https://www.medicalnewstoday.com/health-equity) * [HIV & AIDS](https://www.medicalnewstoday.com/hiv-and-aids) * [Human Biology](https://www.medicalnewstoday.com/human-biology) * [Leukemia](https://www.medicalnewstoday.com/leukemia) * [LGBTQIA+](https://www.medicalnewstoday.com/LGBTQIA) * [Men's Health](https://www.medicalnewstoday.com/mens-health) * [Mental Health](https://www.medicalnewstoday.com/mental-health) * [Multiple Sclerosis (MS)](https://www.medicalnewstoday.com/multiple-sclerosis) * [Nutrition](https://www.medicalnewstoday.com/nutrition) * [Parkinson's Disease](https://www.medicalnewstoday.com/parkinsons-disease) * [Psoriasis](https://www.medicalnewstoday.com/psoriasis) * [Sexual Health](https://www.medicalnewstoday.com/sexual-health) * [Ulcerative Colitis](https://www.medicalnewstoday.com/program/investigating-ulcerative-colitis) * [Women's Health](https://www.medicalnewstoday.com/womens-health) * Health Products Health Products [All](https://www.medicalnewstoday.com/products-and-reviews) * [Nutrition & Fitness](https://www.medicalnewstoday.com/products-and-reviews/nutrition-and-fitness-products) * [Vitamins & Supplements](https://www.medicalnewstoday.com/products-and-reviews/vitamin-and-supplement-products) * [CBD](https://www.medicalnewstoday.com/products-and-reviews/cbd-products) * [Sleep](https://www.medicalnewstoday.com/products-and-reviews/sleep-products) * [Mental Health](https://www.medicalnewstoday.com/products-and-reviews/mental-health-services-and-products) * [At-Home Testing](https://www.medicalnewstoday.com/products-and-reviews/at-home-testing-products) * [Men’s Health](https://www.medicalnewstoday.com/products-and-reviews/mens-health-products) * [Women’s Health](https://www.medicalnewstoday.com/products-and-reviews/womens-health-products) * Discover News * [Latest News](https://www.medicalnewstoday.com/news) * [Medicare 2026 Costs](https://www.medicalnewstoday.com/articles/medicare-costs-3-key-changes-in-2026) Original Series * [Medical Myths](https://www.medicalnewstoday.com/content-series/medical-myths) * [Honest Nutrition](https://www.medicalnewstoday.com/content-series/honest-nutrition) * [Through My Eyes](https://www.medicalnewstoday.com/content-series/through-my-eyes) * [New Normal Health](https://www.medicalnewstoday.com/content-series/new-normal-health) Podcasts [All](https://www.medicalnewstoday.com/articles/in-conversation-podcast) * [ADHD in women: Breaking the stereotypes](https://www.medicalnewstoday.com/articles/adhd-women-breaking-stereotypes-masking-attention-disorder) * [Is sleep the missing piece in mental health?](https://www.medicalnewstoday.com/articles/is-sleep-the-missing-piece-in-mental-health) * [Artificial sweeteners and brain aging: What we know so far](https://www.medicalnewstoday.com/articles/artificial-sweeteners-and-brain-aging-what-we-know-so-far) * [Does the Mediterranean diet hold the key to longevity?](https://www.medicalnewstoday.com/articles/does-the-mediterranean-diet-hold-the-key-to-longevity) * [AMA: Registered dietitian answers 5 key questions about fiber and weight loss](https://www.medicalnewstoday.com/articles/can-fiber-help-lose-weight-dietitian-answers-5-key-questions) * [Health misinformation and disinformation: How to avoid it](https://www.medicalnewstoday.com/articles/health-misinformation-and-disinformation-how-to-avoid-it) * Tools General Health * [Drugs A-Z](https://www.medicalnewstoday.com/drugs) * [Health Hubs](https://www.medicalnewstoday.com/articles/content-hubs) * [Newsletter](https://www.medicalnewstoday.com/newsletter) * [Medicare Plans by State](https://www.medicalnewstoday.com/about/health-medicare-state-coverage) Health Tools * [Find a Doctor](https://connect.medicalnewstoday.com/) * [BMI Calculators and Charts](https://www.medicalnewstoday.com/articles/323586) * [Blood Pressure Chart: Ranges and Guide](https://www.medicalnewstoday.com/articles/327077) * [Breast Cancer: Self-Examination Guide](https://www.medicalnewstoday.com/articles/316898) * [Sleep Calculator](https://www.medicalnewstoday.com/articles/sleep-calculator) Quizzes * [RA Myths vs Facts](https://www.medicalnewstoday.com/articles/science-fact-or-fiction-separating-ra-myths-from-facts#1) * [Type 2 Diabetes: Managing Blood Sugar](https://www.medicalnewstoday.com/articles/managing-blood-sugar-type-2-diabetes-quiz#1) * [Ankylosing Spondylitis Pain: Fact or Fiction](https://www.medicalnewstoday.com/articles/complementary-therapies-for-as-quiz#1) * Connect About Medical News Today * [Who We Are](https://www.medicalnewstoday.com/about) * [Our Editorial Process](https://www.medicalnewstoday.com/articles/process) * [Content Integrity](https://www.medicalnewstoday.com/about/content-integrity) * [Conscious Language](https://www.medicalnewstoday.com/about/conscious-language) Find Community * [Bezzy Breast Cancer](https://www.bezzybc.com/lp/2/?verzenio&utm_source=mnt&utm_medium=nav-bar-connect) * [Bezzy MS](https://www.bezzyms.com/?utm_source=mnt&utm_medium=nav-bar-connect) * [Bezzy Migraine](https://www.bezzymigraine.com/?utm_source=mnt&utm_medium=nav-bar-connect) * [Bezzy Psoriasis](https://www.bezzypsoriasis.com/?utm_source=mnt&utm_medium=nav-bar-connect) Follow Us [](https://www.facebook.com/MedicalNewsToday/)[](https://x.com/mnt)[](https://www.instagram.com/medicalnewstoday/)[](https://www.linkedin.com/company/mednewstoday/?originalSubdomain=ec)[](https://flipboard.com/@MedNewsToday) Subscribe [Human Biology](https://www.medicalnewstoday.com/human-biology) * [Nervous system](https://www.medicalnewstoday.com/human-biology/nervous-system) * [Cardiovascular system](https://www.medicalnewstoday.com/human-biology/cardiovascular-system) * [Respiratory system](https://www.medicalnewstoday.com/human-biology/respiratory-system) * [Digestive system](https://www.medicalnewstoday.com/human-biology/digestive-system) * [Immune system](https://www.medicalnewstoday.com/human-biology/immune-system) # 5 modifiable risk factors may fuel high-risk plaques linked to heart attacks ![](https://i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2020/06/500x500_James_McIntosh.png?w=105&h=105) Written by James McIntosh on July 27, 2026 — Fact checked by Jill Seladi-Schulman, Ph.D. ![An older man gets his blood pressure, a modifiable risk factor for heart disease, checked by a nurse in a nursing home](https://media.post.rvohealth.io/wp-content/uploads/sites/3/2026/07/getty_1458603527_header_1296x728-1024x575.jpg)[Share on Pinterest](https://www.pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-heart-attacks&media=https%3A%2F%2Fmedia.post.rvohealth.io%2Fwp-content%2Fuploads%2Fsites%2F3%2F2026%2F07%2Fgetty_1458603527_header_1296x728-1024x575.jpg&description=Heart%20attack%3A%205%20modifiable%20risk%20factors%20linked%20to%20dangerous%20plaque "Share on Pinterest")A new study aims to explain how 5 common risk factors shape dangerous plaque buildup in coronary arteries. FG Trade Latin / Getty Images * **Modifiable cardiovascular risk factors, such as obesity, type 2 diabetes, and smoking, were associated with the buildup of high risk plaque in the major coronary arteries.** * **Having a greater number of modifiable risk factors was associated with a greater number of high risk, or vulnerable, plaques.** * **High risk plaques are more likely to trigger adverse cardiac events such as heart attacks.** A new study has shed new light on how certain cardiovascular risk factors might alter a person’s risk of adverse cardiac events, such as heart attacks, by noting an association between modifiable risk factors and the buildup of plaques in the coronary arteries. Researchers from Mass General Brigham Heart and Vascular Institute set out to investigate the association between both modifiable and non-modifiable risk factors and the amount and types of plaques found across the three major coronary arteries. Clinical practitioners have long been aware of factors that can influence people’s risk of developing cardiovascular disease. These factors include modifiable ones, which people can change, such as [high blood pressure](https://www.medicalnewstoday.com/articles/150109), [obesity](https://www.medicalnewstoday.com/articles/323551), and [cigarette smoking](https://www.medicalnewstoday.com/articles/10566). They also include non-modifiable factors that people cannot alter, such as age, sex, and a family history of [coronary artery disease](https://www.medicalnewstoday.com/articles/184130). While these risk factors are well-established, most research up until now has focused on looking at them individually, or within specific groups of patients. The new study, published in _[JACC: Advances](https://www.jacc.org/doi/10.1016/j.jacadv.2026.102983)_ , took a different approach by looking at all of these risk factors together to see how the number of risk factors present might relate to plaque formation. ## What did the researchers look at? The researchers examined [optical coherence tomography (OCT)](https://www.medicalnewstoday.com/articles/optical-coherence-tomography) imaging from 131 patients from the Massachusetts General Hospital registry who had not previously received treatment for blocked or narrowed coronary arteries. OCT is an imaging technique using near-infrared light that can provide highly detailed cross-sectional images of blood vessels. Each participant received OCT imaging of their three major coronary arteries. Across all of the patients, this imaging revealed a total of 534 plaques for the researchers to analyze. The researchers then looked to see if there were any associations between the plaques present in the coronary arteries with the risk factors the participants had. They carried out separate analyses looking at modifiable risk factors, non-modifiable risk factors, and total risk factors. ## What did the researchers discover? The study authors found that as the number of risk factors increased, so too did the number of plaques visible in the OCT imaging. **They also observed a greater number of a particular type of plaque, known as thin-cap fibroatheroma. This type of plaque is known to be a high risk, or vulnerable, plaque type that is more likely than other types to trigger adverse cardiac events like heart attacks.** A greater number of risk factors was also associated with a higher number of another type of vulnerable plaque: lipid-rich plaques. Among participants with at least 4 modifiable risk factors, 1 in 2 plaques were thin-cap fibroatheromas, and 4 in 5 were lipid-rich plaques. “The higher the number of vulnerable, or rupture-prone plaques, the greater the chance that one of them will trigger an adverse event,” said senior author [Ik-Kyung Jang](https://www.massgeneral.org/doctors/16370/ik-kyung-jang), MD, in a [press release](https://www.eurekalert.org/news-releases/1136993). ## Modifiable vs. non-modifiable risk factors **The researchers found that it was only an increased number of modifiable risk factors that was associated with a greater spread of these high risk plaques across all three major coronary arteries.** Non-modifiable risk factors were associated with more stable plaque types. The modifiable risk factors recorded in the study were: * high levels of [low-density lipoprotein cholesterol](https://www.medicalnewstoday.com/articles/ldl-cholesterol) * high blood pressure * [diabetes mellitus](https://www.medicalnewstoday.com/articles/323627) * obesity * cigarette smoking _Medical News Today_ asked Dr. Jang why modifiable risk factors might be more associated with the buildup of vulnerable plaques than non-modifiable risk factors. **“We believe that the association between modifiable risk factors and plaque vulnerability is largely mediated by inflammation,” he said. “All five modifiable risk factors—dyslipidemia, hypertension, diabetes, obesity, and smoking—are known to promote vascular inflammation.** “In contrast, non-modifiable risk factors, such as age, sex, and family history, may primarily contribute to the gradual progression of atherosclerosis through pathways less directly driven by inflammation,” he added. ## What comes next? “The natural next step is to test, in a prospective study, whether aggressive management of modifiable risk factors can reduce plaque vulnerability,” Dr. Yang told _MNT_. The researchers acknowledge that the limitations of this study mean that more research is needed before their findings can be generalized to a wider population. The data they analyzed for the study came from a specific pool of hospital patients, who had yet to receive certain types of treatment and who were able to receive OCT imaging. As a result, the study authors say these present findings are only suitable for interpretation among a similar patient population. In order to generalize these findings, the authors suggest that research involving larger groups of people that include people who have received treatment for blocked arteries will be required. Until then, they conclude that their findings underline the importance of targeting modifiable risk factors to help prevent heart attacks. “Our findings highlight the importance of early, intensive and sustained interventions to control the modifiable risk factors and prevent future events,” said Dr. Jang in the press release. * [Cholesterol](https://www.medicalnewstoday.com/categories/cholesterol) * [Diabetes](https://www.medicalnewstoday.com/categories/diabetes) * [Type 2](https://www.medicalnewstoday.com/diabetes/type-2) * [Heart Disease](https://www.medicalnewstoday.com/categories/heart-disease) * [Hypertension](https://www.medicalnewstoday.com/categories/hypertension) * [Cardiovascular / Cardiology](https://www.medicalnewstoday.com/categories/cardiovascular) * [Obesity / Weight Loss / Fitness](https://www.medicalnewstoday.com/categories/fitness-obesity) Share this article [](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-heart-attacks%3Futm_medium%3Dsocial%26utm_source%3Dfacebook%26utm_campaign%3Dsocial-sharebar-referred-desktop "Share on Facebook") [](https://twitter.com/intent/tweet?via=mnt&text=Heart%20attack%3A%205%20modifiable%20risk%20factors%20linked%20to%20dangerous%20plaque&url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F5-modifiable-risk-factors-may-fuel-high-risk-plaques-linked-heart-attacks%3Futm_medium%3Dsocial%26utm_source%3Dx%26utm_campaign%3Dsocial-sharebar-referred-desktop "Share on X") ![](https://i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2020/06/500x500_James_McIntosh.png?w=105&h=105) Written by James McIntosh on July 27, 2026 — Fact checked by Jill Seladi-Schulman, Ph.D. ## Was this article helpful? YesNo [](https://www.facebook.com/MedicalNewsToday/)[](https://x.com/mnt)[](https://www.pinterest.com/medicalnewstoday/?eq=medical%20news%20today&etslf=4441)[](https://www.instagram.com/medicalnewstoday/)[](https://www.youtube.com/channel/UC7snF15Idi7px6XujWe_h9A)[](https://flipboard.com/@MedNewsToday) ## Get our newsletter Keep up with the ever-changing world of medical science with new and emerging developments in health. SUBSCRIBE Your [privacy](https://www.medicalnewstoday.com/about/privacy-notice) is important to us © 2026 Healthline Media UK Ltd, London, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Healthline Media is an RVO Health Company. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. [See additional information](https://www.medicalnewstoday.com/about/additional-information). * [About Us](https://www.medicalnewstoday.com/about) * [Contact Us](https://www.medicalnewstoday.com/about/contact-us) * [Terms of Use](https://www.medicalnewstoday.com/about/terms-of-use) * [Privacy Notice](https://www.medicalnewstoday.com/about/privacy-notice) * Privacy Settings * [Advertising Policy](https://www.medicalnewstoday.com/ad-policy) * [Health Topics](https://www.medicalnewstoday.com/directory/a-b) * [Health Hubs](https://www.medicalnewstoday.com/articles/content-hubs) * [Medical Affairs](https://www.medicalnewstoday.com/about/reviewers) * [Content Integrity](https://www.medicalnewstoday.com/about/content-integrity) * [Newsletters](https://www.medicalnewstoday.com/newsletter) * [Your Privacy Choices](https://privacyportal.onetrust.com/webform/b45407c6-ee79-4a08-912e-02ce898f9a14/6a88ff3d-e0ff-44b3-bb05-e8a2a65072fe?anonymousId=452654ba-de6f-49a0-8d07-8487b46fa91a&orgId=c69bb2d7-c8f5-4d6f-a080-8c2266e12003) * © 2026 Healthline Media UK Ltd, London, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Healthline Media is an RVO Health Company. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. [See additional information](https://www.medicalnewstoday.com/about/additional-information). © 2026 Healthline Media UK Ltd, London, UK. All rights reserved. MNT is the registered trade mark of Healthline Media. Healthline Media is an RVO Health Company. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. [See additional information](https://www.medicalnewstoday.com/about/additional-information). [](https://www.healthlinemedia.com/?utm_source=medicalnewstoday.com&utm_medium=site&utm_campaign=footer&utm_content=logo&transit_id=e3a98e65-1d9c-4497-a06d-a88e09dbbb77) [About](https://www.healthlinemedia.com/?utm_source=medicalnewstoday.com&utm_medium=site&utm_campaign=footer&utm_content=about&transit_id=e3a98e65-1d9c-4497-a06d-a88e09dbbb77)[Careers](https://rvohealth.com/careers)[Advertise with us](https://www.healthlinemedia.com/advertise?utm_source=medicalnewstoday.com&utm_medium=site&utm_campaign=footer&utm_content=advertise&transit_id=e3a98e65-1d9c-4497-a06d-a88e09dbbb77) OUR BRANDS [Healthline](https://www.healthline.com/?transit_id=e3a98e65-1d9c-4497-a06d-a88e09dbbb77)[Medical News Today](https://www.medicalnewstoday.com/)[Greatist](https://greatist.com/)[Psych Central](https://psychc
## Related Clinical Research

- [Waist circumference predicts mortality more than BMI in adults 65+: study findings](https://medichelpline.com/clinical-feed/medical-news-today-0-bmi-vs-waist-size-study-finds-belly-fat-matters-more-than-weight-for-death-risk.md)
- [Sprint intervals boost heart-protective proteins more than moderate cycling, study finds](https://medichelpline.com/clinical-feed/medical-news-today-0-sprints-or-endurance-study-finds-short-workouts-release-heart-protective.md)
- [Climate change worsens health for people with chronic illness](https://medichelpline.com/clinical-feed/stat-news-1-opinion-climate-change-is-making-people-with-chronic-illness-even-sicker.md)
- [New ACC/AHA Guidance on Cardiovascular Care for Tactical Athletes](https://medichelpline.com/clinical-feed/stat-news-1-tactical-athletes-get-new-guidance-for-cardiovascular-fitness.md)
- [Bupropion Hydrochloride for Improving Recovery in Acute Ischaemic Stroke: BASE Trial Protocol](https://medichelpline.com/clinical-feed/bmj-open-4-protocol-for-base-a-multicentre-double-blind-randomised-controlled-trial-of.md)

## Navigation
- [← Back to Cardiology Feed](https://medichelpline.com/clinical-feed/cardiology.md)
- [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md)
## Medical & Regulatory Disclaimer

> [!CAUTION]
> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.