Your blood vessels should be taken care of from a young age
Atherosclerosis is the main cause of cardiovascular and cerebrovascular diseases in young people
When it comes to cardiovascular and cerebrovascular diseases, many people subconsciously think that they are diseases of the elderly. However, in recent years, news reports have included many cases of sudden myocardial infarction and stroke among young people in their twenties; in outpatient clinics, more and more young people are suffering from related diseases. The "China Cardiovascular Health and Disease Report 2024" shows that the age of onset of acute myocardial infarction is still trending younger; the "China Stroke Prevention and Treatment Report 2024" also points out that the incidence of stroke in my country is generally showing a younger trend.
What causes these young people to suffer from cardiovascular and cerebrovascular diseases?
From a clinical perspective, the pathogenesis of cardiovascular and cerebrovascular diseases in young people is relatively complex, with significant individual differences. In addition to genetic, congenital vascular factors and cardiogenic causes, atherosclerosis is the most common pathological basis.
We can think of atherosclerosis as the process in which blood vessels become clogged with fatty plaque. The inner wall of healthy blood vessels is smooth and elastic. When there is too much "bad cholesterol" - low-density lipoprotein cholesterol in the blood, it will pass through the vascular endothelium and be deposited in the subendothelial layer. At this time, the body's immune system will treat these deposits as "enemies" and send macrophages to remove them. Macrophages that have swallowed up too much lipids will turn into "foam cells" and accumulate to form lipid stripes, which are the prototype of atherosclerotic plaques. Over time, more lipids accumulate inside the plaque, and the surface is covered with a fibrous cap, forming mature atherosclerotic plaque.
The existence of these plaques can lead to two serious consequences: First, mechanical stenosis of blood vessels - plaques bulge into the lumen, causing poor blood flow and triggering ischemic symptoms such as angina pectoris. The second is a more dangerous acute event - the fibrous cap ruptures, and the internal procoagulant substances are exposed to the blood, causing rapid formation of thrombus. If the thrombus completely blocks the blood vessel, it may induce serious consequences such as acute myocardial infarction or ischemic stroke.
It is worth noting that the incidence characteristics of cardiovascular and cerebrovascular events in young people are significantly different from those in the elderly. Atherosclerosis in the elderly is usually a degenerative disease that progresses slowly over decades. It is often accompanied by basic diseases such as hypertension, diabetes, and hyperlipidemia. During the course of the disease, collateral circulation gradually forms and has a certain compensatory ability. However, in the acute onset of young people, in addition to unstable rupture of atherosclerotic plaques, non-atherosclerotic factors such as coronary spasm, arterial dissection, vasculitis, and cardioembolism also account for a considerable proportion. Bad lifestyles such as staying up late for a long time and eating an unbalanced diet will accelerate plaque progression or directly induce acute vascular injury. Moreover, the course of disease is shorter in young people, and collateral circulation is often not yet established. Once a blood vessel is acutely occluded or severely spasmed, due to the lack of backup blood flow pathways, the first attack may manifest as acute myocardial infarction or stroke, with more dangerous consequences.
Why is the health of blood vessels at such a young age a red light?
Blood vessels go from being soft and elastic to gradually becoming hard and brittle, which should be a slow process that takes "ten years" as a unit. But now, the younger generation of chronic diseases such as hypertension, diabetes, dyslipidemia, and obesity, coupled with unhealthy lifestyles such as irregular diet, long-term staying up late, and high work pressure, are significantly accelerating this process.
The rise of takeout and fast food culture has greatly changed the dietary structure of contemporary young people. Takeaways are generally high in oil, salt, sugar, and refined carbohydrates, with a serious shortage of vegetables, whole grains, and high-quality protein. Long-term dependence on takeaways and the superposition of multiple risk factors will cause continued damage to the vascular endothelium. A high-salt diet can easily increase blood pressure and increase pressure on blood vessel walls, thereby damaging endothelial cells and weakening their barrier function; a high-fat diet can cause an increase in the concentration of low-density lipoprotein cholesterol in the blood, and these lipid particles will enter the subendothelial layer through the damaged endothelial barrier and be deposited; a high-sugar diet can easily induce insulin resistance and disorders of blood lipid metabolism, which can also lead to the continuous deposition of excess lipids, posing hidden dangers for atherosclerosis.
At the same time, prolonged sitting and insufficient exercise will cause blood circulation to slow down and the body's metabolic efficiency to decrease, leading to the accumulation of lipids and oxidized metabolites in the body, further increasing the metabolic burden on blood vessels.
Staying up late for a long time and a stressful life pace are also important factors in damaging blood vessel health. Staying up late will continue to excite the sympathetic nerves, causing repeated fluctuations in blood pressure and weakening the stability of blood vessels. Due to multiple factors such as workplace competition and life pressure, many young people have been in a chronic stress state of mental stress and emotional anxiety for a long time, which can cause an increase in inflammation levels in the body, may lead to abnormal coagulation function, and significantly increase the risk of sudden cardiovascular and cerebrovascular diseases.
What needs to be especially vigilant is that smoking is an important independent risk factor for damaging vascular health. Thousands of chemicals such as nicotine, carbon monoxide, and free radicals produced by tobacco burning can directly enter the blood and cause damage to the endothelial cells in the innermost layer of blood vessels. In addition, smoking also activates the inflammatory response in the blood vessel wall, turning the plaque from stable to vulnerable, increasing the risk of rupture. Drinking alcohol can also damage blood vessel health. Alcohol can directly damage the vascular endothelium, and even small amounts of alcohol can increase the risk of hypertension, atrial fibrillation, etc.
Pay attention to blood vessel health starting now
The younger generation of cardiovascular and cerebrovascular diseases is essentially a warning that bad lifestyles are overdrafting health. As a young person, there is no need to panic over this, but you should also abandon the idea of taking chances. In fact, risk factors that damage vascular health often begin to accumulate in youth and are easily overlooked because there are no obvious symptoms in the early stages. However, once long-term vascular damage exceeds the body's compensatory limit, the first onset of the disease in some people may directly manifest as acute myocardial infarction or stroke. Therefore, daily monitoring of vascular health and early prevention are crucial.
Screening for risk factors is the first step in prevention. Blood pressure, blood sugar and blood lipids should be monitored regularly to detect potential vascular risks in a timely manner. Compared with blood pressure and blood sugar, the public's awareness of dyslipidemia is relatively insufficient, especially the most dangerous signal - low-density lipoprotein cholesterol. It is the core "raw material" of atherosclerosis and the primary target for lipid-lowering therapy. According to the "China Blood Lipid Management Guidelines (2023)", different risk levels correspond to different low-density lipoprotein cholesterol control targets: for healthy adults, the target should be lower than 3.4mmol/L; for those with risk factors such as hypertension and diabetes, the target should be lowered to below 2.6mmol/L; for those with confirmed cardiovascular and cerebrovascular diseases, the target should be controlled below 1.8mmol/L and the reduction rate should be more than 50%.
In real life, it is sometimes difficult to completely avoid staying up late, working overtime, and relying on takeaways. Health risks can be minimized through some simple adjustments. For example, when choosing takeout, give priority to steamed, boiled, stir-fried dishes, avoid braised, fried and other heavy oil and salt meals, and consciously mix vegetables and multi-grain rice to reduce the intake of refined staple foods; when you have to stay up late, avoid drinking a lot of coffee, strong tea or functional drinks to refresh yourself; during work breaks, choose healthy snacks such as sugar-free yogurt to replace snacks such as potato chips and biscuits.
In the busy work rhythm, young people can also use the fragmented time to engage in "micro-exercises". For example, when commuting, get off the car one stop in advance and walk; do simple stretching during lunch break; get up and move every hour while working to relieve the blood circulation blockage caused by sitting for a long time. Over time, these small changes can help improve your physical condition.
Quitting smoking and limiting alcohol is also of great significance to improving vascular health. There is no "safe dose" of smoking. Quitting smoking is the only and most effective way to protect yourself. The sooner you quit, the more room there is for blood vessel repair. The same is true for drinking. From the perspective of protecting blood vessels, the safest option is not to drink. If complete abstinence is not possible for the time being, gradually reducing the amount of drinking can be used as a transition.
In addition, you should also pay attention to the early warning signals sent by your body in a timely manner. If symptoms such as chest tightness, palpitation, dizziness, shoulder and back pain of unknown origin occur repeatedly, you should rest in time and seek medical examination. Do not simply blame "being too tired" and delay the condition. (Author: Chen Xinping, director of the Hyperbaric Oxygen Department and deputy chief physician of the Department of Neurology at Beijing Haidian Hospital [Peking University Third Hospital Haidian Campus])
Source: Guangming Daily
