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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Healthy Heart Healthy Heart

How To Stay Young -- Really!

June 27, 2013

By Thomas H. Lee M.D.

Harvard Medical School

Last reviewed by Faculty of Harvard Medical School June 27, 2013

The baby boomers are getting older, and it's not pretty. A lot of money is being spent on Botox, liposuction, plastic surgery and personal trainers. Ultimately, these efforts to continue to look good are, in part, doomed to failure. That is, they may be able to fight off the effects of aging on the outside, but they don't slow down aging on the inside. The fact is that you are as young as your blood vessels.

You are probably thinking, "I don't care how I look on the inside." But being young isn't just about looking good. It's about having a good chance of living for many years to come. And young, healthy blood vessels mean a lower risk for many of the most common causes of death — heart attack, stroke and kidney disease.

What does it mean to have young, healthy blood vessels? Children, teenagers and young adults who do not have early signs of atherosclerosis have arteries (the blood vessels that carry blood from the heart to the organs of the body) that are supple and compliant. These arteries can expand with each surge of blood that is pumped by the heart, so that blood pressure rises only a small amount rather than shoots up.

This smaller rise in blood pressure with each heartbeat means you have a lower risk of a blood vessel breaking open due to high pressures. It also means that you don't have much atherosclerosis — the deposits of fat and scarring of artery walls that ultimately cause most heart attacks and strokes.

What happens to most people in America as they develop wrinkles and a paunch is that their arteries become stiff. Age and atherosclerosis start to harden the arteries. The result is high blood pressure, and a higher risk of stroke, heart disease and blockages in the arteries to the legs and kidneys.

How can you tell if this is happening to you? There are tests that researchers use to test the healthiness of people's arteries, but you don't really need anything fancy. If your blood pressure is high — such as a systolic pressure above 130 millimeters of mercury (mmHg) or a diastolic pressure over 85 mmHg — the chances that your arteries are feeling their years are high. The top number is, in many ways, even more important than the bottom number, because "stiff pipes" lead to big surges in blood pressure with each heartbeat. So, if your top number alone is elevated, or if the gap between your top and bottom number is high (for example, greater than 50 mmHg), then your arteries are aging.

The really, really good news is that you can keep your arteries young — much more effectively than you can try to hold off the superficial manifestations of aging. A few simple strategies that you've heard of before have all been shown to slow down and even reverse the signs of aging blood vessels. These tactics include:

  • Exercise as much as possible — Get at least 30 minutes, ideally every day.
  • Control your cholesterol — Reducing elevated LDL cholesterol has been shown to help restore flexibility to arteries.
  • Control your blood pressure — Constant exposure of blood vessels to pressures above normal takes its toll.
  • No smoking — The chemicals in cigarette smoke are killers of blood-vessel health.

No matter how old you are, these tactics can help your blood vessels stay young. You may be aging on the outside, but if your arteries are healthy you can avoid dying young and leaving a beautiful corpse.

Thomas H. Lee, M.D. is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance.

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