Preventing blood clots

Preventing blood clots


We have learned to fear cholesterol — that evil substance that silently accumulates along

artery walls, year after year, until it eventually kills its victim by choking blood flow to an important organ such as the heart or brain. But cholesterol is not the only villain in this artery disease melodrama. While cholesterol contributes to the formation of arterial plaque, the gunk that builds up on the artery walls, the antagonist delivering the final blow is often a blood clot that forms in a blood vessel and subsequently blocks a narrowed artery, cutting off circulation to the tissues downstream.

Why do clots form inside blood vessels?

The ability to form clots is essential for survival, because this prevents blood loss from injured blood vessels. Unfortunately, the factors responsible for performing the clotting process cannot distinguish between blood vessels injured by a cut or blow from those injured by the process of artery disease, or atherosclerosis. When the blood encounters the rough surface of arterial plaque, it responds by initiating the clotting process. In this case, clotting does not help damaged blood vessels, but exacerbates plaque development and arterial obstruction. The process in which clots form inside intact blood vessels is known as thrombosis.

Can I do anything to prevent this process?

People at high risk may already be receiving special medications that prevent clotting. Healthy people cultivating a heart-healthy lifestyle are probably already doing many things that help prevent thrombosis along with atherosclerosis. These include:

Quitting smoking. Smoking increases clotting risk. It makes platelets, the blood cells that participate in the formation of clots, stickier. Sticky platelets are more likely to clump together and kick off the clotting process.

Regular physical activity. Regular physical activity “thins” the blood; it increases the proportion of plasma, the liquid portion of the blood, to the blood cells. Dilute blood is less prone to clotting. Vigorous exercise reduces the tendency of platelets to clump together, and enhances the ability of the body to dissolve blood clots already formed. This process is known as fibrinolysis. Fibrinolysis is a natural healing process that dissolves very small blood clots before they can do any harm.

Stress. In the days of cave people, fighting and fleeing were often associated with bleeding, so it makes intuitive sense that enhanced clotting speed is part of the fight-or-flight response, even though clotting is not so useful nowadays. Studies have also demonstrated that stress reduces fibrinolysis.

Heart-healthy diet

People with high blood cholesterol levels have a greater clotting speed, lower fibrinolysis and stickier platelets than people with low blood cholesterol levels. Lowering blood cholesterol levels by diet or drug therapy seems to reverse these problems. A heart-healthy diet appears to not only slow or reverse the growth of arterial plaque, but may also reduce heart disease risk by making the blood “healthier” and less prone to thrombosis. An interesting study from Denmark found that volunteers who stuck to a low-fat, high-fiber diet showed increased fibrinolytic activity and, thus, a reduced risk of blood clot formation.

A moderate alcohol intake (one to two drinks per day) has been associated with a reduced heart disease risk. This risk reduction may be due in part to the increase in fibrinolysis observed in moderate drinkers.

Are there any additional lifestyle
factors I should be aware of?

The factors referred to above are the most important. Your heart-healthy lifestyle prevents clotting in at least four ways. First, directly by its effects on the factors associated with thrombosis. It also prevents clotting by preventing artery disease, since arterial plaque activates the clotting process. Third, by preventing high blood cholesterol, your heart-healthy lifestyle improves the health of your blood, as described above. High blood pressure, even borderline high blood pressure, is associated with increased clotting risk and diminished fibrinolytic activity, so your heart-healthy lifestyle helps you a fourth time by reducing your risk of hypertension.

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