http://www.deccanchronicle.com/channels/lifestyle/health/you%E2%80%99re-old-your-arteries-868
Atherosclerosis takes away hundreds of lives every day and it is important to understand and avoid the risk factors
Arteries, which carry blood from heart to other body parts are not simple conduits, but living organs. They contract, relax, let fluid and nutrients pass though when required.
Narrowing down of these smooth vital arterial system is the cause for most non-communicable diseases like heart attacks and brain stroke. Rudolf Virchow, a German pathologist in the 19th century was the first to realise this. From the post mortem specimens, he concluded that the narrowing happened because of the thickening of the arterial wall, resulting in deposition of fatty, gruel like materials. He named it atherosclerosis, (athero – gruel).
If you take Kerala, it has a life expectancy of 72 years, which is a decade more than the national average. But there are other statistics, which are shocking. An estimated 1.5 lakh people suffer from a heart attack every year in Kerala, and 38,000 die of it. That makes 110 deaths daily due to heart attack itself. Add up stroke and you realise the enormity of the problem.
Atherosclerosis results from many risk factors like diabetes, smoking, high blood pressure and high cholesterol. These tend to damage the thin smooth inner lining of the arterial system — the endothelium. Once endothelium is damaged, fat in the blood tends to percolate inside the arterial wall causing thickening and narrowing of the arteries. Progressive narrowing results in stroke and heart attacks.
The process of atherosclerosis is age dependent, as the age advances, our arteries thicken, the lumen narrows. But this ‘physiological’ thickening does not cause a problem. The pathologically ‘accelerated’ atherosclerosis is what results in blockage at a very young age.
Atherosclerosis among youth is almost always associated with risk factors mentioned above. The risk factors need not be ‘severe’ to cause arterial block in young people. A combination of mild diabetes (fasting blood sugar between 110 to 126 mg per cent), slightly elevated blood pressure (systolic blood pressure 12 to 140 mm Hg) with smoking (10 cigarettes a day) may kick-start accelerated atherosclerosis. Beyond these risk factors, we have unpronounceable diseases like hyperhomocysteinemia which fortunately are rare. Even our genetics do determine the progression partly, at least in high-risk families.
How do we prevent accelerated atherosclerosis? Taking care of risk factors like diabetes, high blood pressure and high cholesterol are most important. You may feel healthy. But only a check up would show whether you have slightly elevated blood sugar, or blood pressure or cholesterol. ‘Know your enemy before it strikes’ is the motto. Don’t smoke, don’t let your friends smoke. Passive smoking is a major risk factor for the increase in atherosclerosis in today’s world. And be happy, take things easy. Stress releases hormones, which are not liked by your endothelium. Sir William Osler, the father of modern medicine said, “You are as old your arteries.”
The writer is president, Cardiological Society of India — Kerala chapter and head, dept of cardiology, PRS Hospital, Thiruvananthapuram
