by Dr. John Neustadt

Healthy blood vessels are necessary for healthy blood pressure and reducing your risk for a heart attack and stroke. There are nearly 800,000 strokes in the U.S. annually, and as our population ages, those numbers are projected to soar.¹ The impact is even greater, however, when you include subclinical cerebrovascular disease. These “silent strokes,” which don’t produce outward symptoms and are identified on brain imaging, occurs in up to 28% of people over age 65. Meanwhile, nearly 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Heart disease is the leading cause of death for both men and women.²

The most important risk factor for having a stroke is high blood pressure.³ High blood pressure also increases your risk of a heart attack. But why exactly do blood vessels get stiff and create high blood pressure? And, importantly, what can you do to improve blood vessel elasticity and support healthy blood pressure? 

When you feel your pulse—for example in your wrist or neck—that’s your arteries expanding and relaxing as the heartbeats and pumps blood through the body. With each heartbeat, this muscle that never sleeps creates a “wave” of blood traveling away from the heart. When you check your blood pressure, it indicates how hard the heart has to pump to move blood through the body. High blood pressure means added stress is being put on your heart and blood vessels. 

Two major components influence blood pressure: the flexibility (or stiffness) of arteries and veins, and the thickness (or blood viscosity) of blood. Both impact how easily blood flows through the circulatory system. This blog discusses how you can support  healthy arterial elasticity.

Arterial stiffness increases as we age and predicts stroke risk and even recovery after a stroke.⁴ It’s also a powerful independent predictor of heart disease,⁵ cognitive impairment and Alzheimer’s disease,^6,7 and death from all causes (“all-cause mortality”).⁸ In people with rheumatoid arthritis, arterial stiffness predicts more disability.⁹ Even conditions like depression and osteoporosis have been found in multiple studies to correlate with arterial stiffness, suggesting that the health of the arterial wall is intimately connected to overall health and its many manifestations.¹⁰

60,000 Miles of Blood Vessels

Your marvelous cardiovascular system is composed of arteries, veins, capillaries and the heart. If your blood vessels were laid out end to end they would stretch for an astonishing 60,000 miles—long enough to take a cruise ship around the world twice.¹¹ 

Arteries carry oxygen-rich blood away from the heart, delivering it to all the tissues of the body. As arteries branch out they become smaller and smaller, like an interstate turning to side streets and finally small alleyways. Veins carry blood that is depleted of oxygen, but also has waste from cells, back to the heart; they in turn get larger as they approach the heart. The waste products will be disposed of and the heart will once again enrich the blood with oxygen for the next journey into the arteries and through the body. 

When the arterial wall stiffens and becomes less elastic, a smaller amount blood flows through the blood vessels, and the “wave” that carries the blood through normally flexible arteries is reduced. This requires the heart to pump harder to circulate the same amount of blood, dangerously increase the amount of pressure in the arteries and can reduce the amount of blood reaching your kidneys, liver, intestines, brain, muscles, and other organs. The reduction in delivery of oxygen and nutrients can in turn make it harder for tissues to do their job and cause further damage. 

Over time, elevated blood pressure can weaken arteries and cause them to bleed out. When this happens in the brain, it’s called a stroke. The added work on your heart over time can also damage it and people with high blood pressure are more likely to develop atherosclerosis (hardening of the arteries). 

Top Ways to Support Healthy Elasticity

Arterial stiffness and cardiovascular disease are not inevitable. Arterial stiffness can be prevented and reversed by many lifestyle factors. Things you can do to reduce your risk include: 

• Don’t smoke cigarettes or stop if you do^12,13
• Maintain healthy blood pressure and cholesterol¹⁴
• Reduce triglycerides if elevated and increase HDL (the good cholesterol) if low¹⁵
• Prevent and reverse metabolic syndrome¹⁶
• Reduce inflammation and oxidative stress^17,18,19
• Additionally…

Exercise

Moderate or vigorous physical activity reduces the risk of arterial stiffness, while a sedentary lifestyle increases it.²⁰ One ten-year study found that 150 minutes of moderate to vigorous physical activity each week was associated with less arterial stiffness.²¹ 

Diet

With every bite of food you’re either creating health or feeding disease. Diet is one of the biggest predictors of chronic diseases, including cardiovascular disease, and early death. But the beautiful thing is that regardless of your age, research shows that changing your diet improves your health and reduces your risk. 

Reduce Salt

If you’re eating the Standard American Diet (SAD) you’re consuming too much salt. A low salt diet can be protective.²² While you can read labels that emphasize low-sodium prepared foods, you will naturally be eating less sodium if you transition away from a SAD and toward a whole foods, Mediterranean Diet. 

Improve Blood Sugar 

Elevated blood sugar, seen in metabolic syndrome and diabetes, increases vascular stiffness.²³ Reducing sugar in the diet, eating a more whole-foods, plant-based diet, and exercising can all help improve blood sugar control. 

Eat Plants 

A plant-based, whole foods diet provides vitamins, minerals, antioxidants and other nutrients with powerful effects on blood pressure. A randomized, controlled clinical trial (the gold standard in medical research) published in 2019 in the journal Hypertension followed nearly 1300 adults (65-79 years old) with high blood pressure. After a year, those following a Mediterranean diet significantly reduced their blood pressure and arterial stiffness.²⁴

Other research that looked at dietary patterns across ethnicities and races in US adults discovered that not eating enough green leafy vegetables is an independent predictor of high arterial pulse pressure. Green leafy vegetables include kale, spinach, turnip greens, collards, Swiss chard, mustard greens, parsley, romaine, and green leaf lettuce.²⁵ 

But you don’t have to wait an entire year to experience the benefits of eating more of a whole foods diet. Researchers fed volunteers two meals that were rich in spinach. In addition to containing vitamin K1, magnesium, and other nutrients, spinach is a great source of nitrate. Other vegetables that contain high amounts of nitrate include lettuce, beetroot, celery, spinach, Chinese greens, other leafy greens, parsley, and related herbs. Nitrate helps arteries to relax and can reduce blood pressure. After only two meals, blood pressure and arterial elasticity both significantly improved.²⁶

So your parents were right—eat your vegetables.  

But you can also enjoy some dark chocolate and tea. Research shows that flavonoids, a class of food compounds found in cocoa, tea, and other foods can be helpful. A flavonoid rich diet full of fruits and vegetables is linked to less severe arterial stiffness.^27,28

For my step-by-step guide to transitioning to a Mediterranean diet and eating healthy for life, see Dr. Neustadt’s 3-Steps to Eating Healthy for Life.

Omega-3 Fatty Acids

Making sure you get enough omega-3 fatty acids is important for cardiovascular health and may protect against arterial stiffness.²⁹

Drink Tea

Regular tea consumption can have protective effects against arterial stiffness.³⁰

Turmeric

Turmeric, that golden spice found in curry and popular today for everything from tea to “golden milk”, has significant cardiovascular benefits, including supporting healthy arterial elasticity.³¹ I love adding turmeric to my morning smoothie recipe.

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