How to detect vascular age

People age, and blood vessels age, just like tree rings. The age of blood vessels determines a person's health and lifespan.

People are born like brand new machines. Children's blood vessels are elastic and the inner wall is as smooth as satin, without too many potholes and spots. As they age, lipid streaks begin to appear on the inner wall of blood vessels, just like rust inside metal pipes. Under the influence of age and various risk factors (abnormal blood pressure, blood lipids, and blood sugar indicators), these lipid streaks gradually grow into plaques (atherosclerotic lesions), thus starting the long process of atherosclerotic disease development. If not controlled and intervened, the growth and increase of plaques will be accelerated.

In the early stages of plaque formation, blood flow is not affected, but as plaques grow and lipids accumulate within them, blood flow begins to be restricted. Especially when people exercise, the organs' demand for oxygen increases, but oxygen supply is limited due to the narrowing of blood vessels, resulting in manifestations of organ ischemia, such as angina pectoris and intermittent claudication.

In fact, the most terrifying thing is not the size of the plaque, but the instability of the plaque. Just like dumplings with large fillings and thin skins are easy to break when cooked, unstable soft plaques are particularly prone to erosion and rupture. Plaque rupture and then form blood clots, which quickly block or even block the artery. Blood cannot flow through, and organ tissues cannot get blood and oxygen, which will cause necrosis. No matter which artery this happens to, it will cause corresponding symptoms and diseases, such as myocardial infarction, cerebral infarction, etc. In severe cases, even death, which is medically called vascular death.

If the life span is long enough, everyone's blood vessels will develop atherosclerotic lesions. Many elderly people's blood vessels are becoming less and less elastic, and the lumen of the blood vessels is becoming narrower and narrower, just like a hollow tube becoming solid. Some blood vessels are severely calcified, like steel pipes. Born with unobstructed blood vessels, old with arteriosclerosis, sick with stenosis, and die from thrombosis, this is a physiological phenomenon that most people cannot escape.

So, how to detect vascular age?

First of all, you can roughly guess your vascular age without checking any indicators. A healthy lifestyle, an optimistic attitude, and good interpersonal communication are the most important signs of vascular rejuvenation. On the contrary, blood vessels are prone to aging. Therefore, clinically, a comprehensive assessment of risk factors is first conducted, such as lifestyle (including diet, exercise, smoking, etc.) and basic examinations (including weight, blood pressure, blood lipids, blood sugar, etc.). The focus is to determine whether you have atherosclerotic cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease through medical history and related examinations. If you are sick, no matter how old you are physically, your blood vessels cannot be considered young.

Secondly, carotid vascular ultrasound examination can detect the thickness of the vascular intima and whether there are plaques, as well as evaluate the size and range of the plaques, whether they are hard plaques (strong echoes) or soft plaques (low echoes). If it is a soft plaque, it often indicates a vulnerable plaque that is easy to rupture and requires active intervention. The carotid artery is examined instead of the coronary artery and cerebral blood vessels, mainly because the carotid artery is very superficial and can be easily detected and evaluated by ultrasound. The carotid artery is actually a window, just like investigating forest pests and diseases. We cannot check each tree one by one. If there is an insect pest in a certain forest or even a certain tree, it means that other trees may also have or are about to have pests and diseases. The discovery of plaques by vascular ultrasound examination does not mean that the plaque will definitely fall off and cause danger. More importantly, it is an indicator of systemic atherosclerosis.

Vascular age is closely related to the future occurrence of myocardial infarction, cerebral infarction and vascular death. The size and number of plaques are not the most important, but whether they rupture is the most important. Echocardiography, also known as cardiac color ultrasound, can only evaluate the size, structure and function of the heart, and cannot be used to detect intravascular plaques and assess vascular age.

In short, lifestyle determines blood vessel health. The best way to keep blood vessels young is to develop a healthy lifestyle, eat a balanced diet, exercise moderately, quit smoking and limit alcohol consumption, maintain a balanced mentality, and work hard to change bad living habits. (Xu Juntang, chief physician of the Department of Cardiology, Peking University People's Hospital)