How old are your arteries?

SOME SIGNS THAT YOUR ARTERIES ARE AGEING FASTER THAN YOU ARE

Cardiovascular disease (CVD) manifestations pose a substantial threat to Jamaican’s public health. Every day we hear that one of our friends or relatives has been affected by a heart attack, a stroke, heart failure or a circulation problem.

In medicine, we call these heart problems or interruptions of the blood flow a cardiovascular event which are the result of damage to our hearts or our arteries. There is almost always a history of uncontrolled high blood pressure, high cholesterol, diabetes, being obese or heavy smoking and sooner or later it becomes obvious that the person was at a state of risk. Doctors refer to this as: risk factors.

As we know, our heart’s function is to pump blood through arteries and the arteries (vascular system) carry oxygenated blood away from the heart to all our organs while veins carry blood back. Generally, and in unique different ways, a person with risk factors will develop a heart or vascular disease over a long period of time during his or her life before becoming a victim of a cardiovascular event.

Since the damage to our arteries health represents a mediating step between the risk factors and a CVD event, the Early Vascular Ageing (EVA) has been recognised as a useful concept to better guide prevention measurements and medical investigations in subjects at increased cardiovascular risk.

‘Normal vascular ageing’ refers to the gradual, expected changes in blood vessels (arteries) that occur with natural ageing, primarily characterised by decreased arterial elasticity and increased stiffness, while EVA indicates a significantly accelerated version of this process, often occurring at a younger age and potentially signifying an increased risk for cardiovascular disease, usually marked by significantly higher arterial stiffness than what is typical for someone of the same chronological age.

Vascular age is a measure of the age of your arteries and is a predictor of cardiovascular disease. Many times, the traditional risk factor-based screening fails in identifying the vulnerable patient and this explains why we hear that a certain person with many risk factors is apparently well, and that another with known very healthy lifestyle, without high blood pressure, high cholesterol or diabetes or even a vegetarian, has suffered from a recent and serious cardiovascular problem.

Since atherosclerosis (hardening of the arteries, with buildup process of plaques in the arteries) begins early in life, it should be detected prior to a major CV event. This highlights the importance of Subclinical Disease Detection, that is, before the damage to our arteries causes a disease with unfortunate consequences.

EVOLVING FROM THE STATE OF ‘SICKCARE’ TO ‘HEALTHCARE’

We cardiologists have learned that we must take care of the health of the arteries and do not wait for them to become sick and threaten the lives of our patients. To this end, we use certain tests to evaluate the vascular age and signs of premature ageing of the arteries, such as ‘arteries ultrasound’ and some measurements of the arteries thickness, pulsatility, and stiffness. Arterial stiffness integrates the long-lasting effects of all identified and nonidentified CV risk factors and, thus, may be considered as a vascular health marker.

WHAT SHOULD BE DONE TO COUNTERACT THE PROCESSES REFLECTED IN THE EVA CONDITION?

To use a classical dichotomy, the answer is ‘ADAM’, which stands here for Aggressive Decrease of Atherosclerosis Modifiers (the CV risk factors). The vascular age (Arterialstiffness) is a cumulative measure of the damaging effects of CV risk factors on the arterial wall with ageing. It reflects the true arterial wall damage of CV risk factors associated with ageing. Therefore, to counteract this process do the following: Control the blood pressure level, sugar level (glycemia), fats (cholesterol) levels, keeping physically active, choosing a healthy diet, stop smoking, and taking care of our weight. If we do this, we may significantly influence the effects of ageing in our arteries.

“A man is as old as his arteries” – Thomas Sydenham, 1624-1689.