Pul­se wave and vas­cu­lar age — Arte­ries expi­re, too


Pul­se Wave and Bio­lo­gi­cal Age

Arte­ries expi­re, too 


Arte­ries trans­port oxy­gen-rich blood from the heart throug­hout the body. If you are young and healt­hy, your blood ves­sels are wide enough in dia­me­ter to allow blood to flow easi­ly through them. At this point, the arte­ri­al walls are still fle­xi­ble enough to expand and con­tract as nee­ded and can easi­ly absorb the hard pres­su­re shocks of the heart.

As we age, the arte­ries har­den and lose fle­xi­bi­li­ty: plaque — con­sis­ting of cho­le­ste­rol, fat, cal­ci­um, and fib­rous tis­sue — builds up insi­de, and the ves­sels beco­me incre­asing­ly nar­row. This pro­cess, known as atheros­cle­ro­sis, is asso­cia­ted with a high risk of heart attacks, strokes, and peri­phe­ral artery dise­a­se (PAD): Arte­ri­al aging beg­ins much ear­lier than most would think.

How arte­ries age 

Atheros­cle­ro­sis usual­ly beg­ins in the teens and 20s, and by age 30, we can see chan­ges in most peo­p­le,” says car­dio­lo­gist Matthew Sor­ren­ti­no MD, pro­fes­sor at the Uni­ver­si­ty of Chi­ca­go Medicine’s Bucks­baum Insti­tu­te for Cli­ni­cal Excel­lence. In the ear­ly stages, results of heart-rela­ted scree­ning tests, such as cho­le­ste­rol scree­nings, are usual­ly still con­side­red normal.

Howe­ver, as peo­p­le age, the pro­blem usual­ly gets worse: By age 40, about half of us have cho­le­ste­rol depo­sits in our arte­ries, Sor­ren­ti­no says. After age 45, men have num­e­rous plaque depo­sits in their blood ves­sels. In women, the first signs of atheros­cle­ro­sis usual­ly appear after age 55.

Com­pa­ri­son of the radi­al pul­se waves of two 55-year-old men — at the same scaling.
The green cur­ve is age-appro­pria­te in its pro­gres­si­on. In con­trast, the red cur­ve shows the gra­ve dif­fe­rence bet­ween the patient’s vas­cu­lar and actu­al age: The ela­s­ti­ci­ty of the arte­ries of the 55-year-old man cor­re­sponds to that of an 80-year-old, and the flow resis­tance to that of a 75-year-old.

Risk Fac­tors and Asso­cia­ted Conditions

It’s not just age that affects the arte­ries. Life­style also plays a role: obe­si­ty, smo­king, lack of exer­cise, and con­sump­ti­on of foods high in dan­ge­rous trans fats exert an influence on the con­di­ti­on of the ves­sels. Added to this is fami­ly histo­ry and, thus, gene­tic fac­tors. As a result, some peo­p­le expe­ri­ence chest pain, fati­gue, or short­ness of breath in the later stages of atheros­cle­ro­sis. Some, howe­ver, do not noti­ce any symptoms.

All the more important is to assess the likeli­hood of deve­lo­ping the accom­pany­ing sym­ptoms of aged arte­ries, Sor­ren­ti­no says. Various fac­tors play a role in risk assess­ment. For exam­p­le, cho­le­ste­rol levels and other spe­ci­fic mar­kers in the blood count are included in the eva­lua­ti­on, as is weight and, of cour­se, the enti­re medi­cal and fami­ly histo­ry. The linch­pin of an indi­vi­du­al risk pro­fi­le, howe­ver, is to deter­mi­ne the hemo­dy­na­mic pro­per­ties of the arte­ries. Cen­tral and peri­phe­ral blood pres­su­re mea­su­re­ments based on Model-based Pul­se Wave Ana­ly­sis (mbPWA) iden­ti­fy the likeli­hood of an emer­gen­cy, such as a heart attack or stro­ke, in the next few years. It also unequi­vo­cal­ly deter­mi­nes the likeli­hood of peri­phe­ral vas­cu­lar occlu­si­on (arms or legs) at a very ear­ly (often still asym­pto­ma­tic) stage.

Pro­tect yours­elf from atherosclerosis


Alt­hough you can’t chan­ge your actu­al age or fami­ly histo­ry, being proac­ti­ve is cru­cial to kee­ping your arte­ries healt­hy for as long as possible.

Take regu­lar exer­cise, eat a balan­ced diet, lose excess pounds, and don’t smo­ke, says Sorrentino.

Also always advi­sa­ble is a visit to the doc­tor to cla­ri­fy whe­ther the­re is a risk of atheros­cle­ro­sis. Some­ti­mes, effec­ti­ve life­style chan­ges like Sor­ren­ti­no recom­mends are all nee­ded. In the case of advan­ced atheros­cle­ro­sis, depen­ding on the indi­vi­du­al pati­ent, it is recom­men­ded to take medi­ca­ti­on to redu­ce the risk of a heart attack or stroke.