Did you know that the human body's vascular system - the network of blood vessels, veins, capillaries, and arteries - is about 60,000 miles long? Its job is to carry oxygen-rich blood to cells and provide them with nutrients. Then the blood journeys through the liver where waste and carbon dioxide is removed. Finally, it continues back to the heart, where it starts the process all over again. This entire journey takes only around 20 seconds.

Often, however, this vast network gets blocked, and like any pathway that becomes obstructed, problems occur. Vascular diseases are a group of diseases caused by restricted blood flow in the vessels of the body, making them incapable of supplying adequate blood to the organs. Vascular diseases are a common cause of illness, disability, and death. A complete understanding of these conditions is important in order to take preventive measures against them.

Atherosclerosis and Vascular Diseases

Blockages can occur anywhere in the vascular network. Large and medium-sized vessels like the coronary arteries that supply the heart and carotid arteries that supply the brain, are more prone to blockage. Renal vascular disease occurs when vessels supplying the kidney are blocked, while vessel blockages in the limbs are called peripheral vascular disease. Even the smallest vessels in the body can be blocked.

Regardless of the location of the blockage, the underlying cause for the blockage remains the same: atherosclerosis. Atherosclerosis is the hardening of blood vessels due to the deposition of abnormal fats, cholesterol, calcium, and other substances in the walls of blood vessels. These deposits continue to grow and narrow blood vessels, initially compromising and later completely blocking blood flow. These deposits are called "atherosclerotic plaques" or simply "plaque". Plaques can rupture and throw out small pieces which can travel in the blood stream and block the smaller vessels. When these vessels rupture, small clots form on their surfaces, which in turn can get dislodged to block further smaller vessels.

Coronary artery disease refers to heart problems caused by narrowed coronary arteries. This narrowing compromises the blood flow to the heart. The common symptoms of the disease are discomfort or pain in the chest. This typically occurs when the heartbeat increases and the heart needs more oxygen to pump blood. The compromised blood flow cannot match this demand, which deprives the heart of the required blood supply. The symptoms are relieved upon rest or by taking medications, which relax and broaden the diameter of the vessels.

Heart Attack

When the blockage in the coronary vessels is large or completely stopped, the heart is deprived of blood and oxygen. The heart muscle becomes damaged and starts dying. This damaged muscle is then replaced by scar tissue which results in a heart attack or "myocardial infarction." A heart attack may be surprisingly silent with no symptoms or may manifest as an excruciating pain, most commonly in the chest. Depending upon how severely the heart muscles are damaged, a heart attack can result in disability or death.

Stroke

Stroke is a condition where the brain is deprived of adequate blood supply. There are two types: ischemic stroke, which is caused by blockage, and hemorrhagic stroke, which results from the rupture in the arteries that bring blood and nutrients to the brain. When blocked, these vessels deprive oxygen to parts of the brain. The nerve cells begin to die due to lack of oxygen.

Stroke can have permanent, calamitous effects because dead brain cells cannot be replaced. The part of the body controlled by the affected segment of brain stops working and results in residual disability, for example the inability to move a hand or leg or the loss of speech.

The process of atherosclerosis is universal with aging and is expedited by high blood pressure, high blood glucose (diabetes), smoking, and altered levels of harmful fats in the blood, especially high levels of cholesterol and triglycerides. However, damage from vascular disease can be prevented by controlling the risk factors which underlie the process of atherosclerosis. They are the three E's of prevention: elimination, eating right and exercise.

• Elimination: If you are a smoker, quit. Smoking raises your blood pressure which can lead to atherosclerosis. Avoid excessive consumption of alcohol; overindulging also raises blood pressure.
• Eat right: High blood pressure, harmful fats, and glucose in blood can be controlled by diet and exercise; so, watch what you eat. Adopt a healthy meal plan with more fiber. Eat plenty of fruits, vegetables, and whole grains, all of which are rich sources of fiber. In your body fiber binds to excess cholesterol and prevent its absorption in intestine. Also, avoid fried and fatty food. Select low-fat dairy products. Limit fast food, sweets and sweetened drinks, as these are rich in calories. If you are hypertensive, limit the quantity of salt in the diet.
• Exercise: Walking is the simplest physical activity, and it works wonders. Walk for at least 30 minutes daily. Exercise also helps eliminate the effects of stress on the body. You can also beat the stress by adopting relaxation activities or techniques like reading, listening to music, yoga, or meditation.

Medicines can help to reduce the risk of heart problems or stroke. If you are at a risk of coronary disease or stroke or have suffered from one in the past, you may be a candidate for aspirin therapy. Aspirin interferes with the clotting mechanisms in the body. Whenever there is injury, the blood cells called platelets accumulate to form a clot and seal minor bleeding sites. Such clots are common on the ruptured surfaces of the atherosclerotic plaques which are seen in vascular diseases of the heart and brain. Aspirin reduces the clumping of platelets and prevents further narrowing of the blood vessels.

Statins are another class of medicines used to fight vascular disease. They lower cholesterol levels and are useful in preventing heart attacks and strokes. You may also need medications to control your blood pressure, diabetes, and other fats if these cannot be controlled by diet and exercise alone. 

Keeping the Blood Vessels Healthy

Blood vessels are the lifelines of our body. When the blood vessels are damaged, the body also suffers due to lack of oxygen and nutrition. A healthy lifestyle can help prevent many complications due to vascular disease. The journey of 60,000 miles begins with that first step towards prevention.