AGEING OF ARTERIES

Part 1 of the journey.

In your 20s

Your arteries are generally healthy and clear of obvious diseases though research shows the disease and ageing process has already begun. Harm from tobacco smoke, cholesterol and a sedentary lifestyle can be accumulating.

In your 30s and 40s

Accumulation of fatty deposits called plaque typically begins to accelerate in men. Women are generally protected in their major arteries until after menopause, though disease may begin in smaller vessels. Cholesterol, tobacco smoke, high blood pressure and high blood sugar all cause persistent injury to the inner lining of the artery.

In your 50s

The assault on the inner lining of the arteries continues while the vessel wall becomes stiffer and more fibrous. High blood pressure creates damage apart from plaque build-up that makes arteries less elastic or compliant, increasing the workload on the heart. Injured tissue becomes scarred and calcified. For women, for whom disease tends to develop 10 to 15 years later than for men, the accumulation of plaque begins to accelerate.

In your 60s and beyond

The ageing process, partly reflecting the arteries withstanding more than 100,000 heart beats a day, contributes to the attack on the lining of the arteries. Meanwhile, left ineffectively unchecked, plaque can rupture or erode, leading to blood clots that can cause heart attacks, while an overworked or scarred heart increases the risk of heart failure.

Plaques have various sizes and shapes. Some plaques are unstable and can rapture or burst. When this happens, it causes blood clotting inside the artery. If a blood clot totally blocks the artery, it stops blood flow completely. This is what happens in most heart attacks and strokes. The cumulative effect of all these age-related changes can be boiled down to this: the ability of larger blood vessels to expand and contract diminishes, the lumen enlarges and the arterial walls thicken. The result is hardened or stiffened arteries that set the stage for the onset of high blood pressure, elevated pulse wave velocity, atherosclerosis and other precursors of cardiovascular disease.