Understanding "Vertebrobasilar Arteriosc

Understanding "Vertebrobasilar Arteriosclerosis" and "Bilateral Arteriosclerosis": Health Warnings from Blood Vessels

 

In physical examination reports, "vertebrobasilar arteriosclerosis" and "bilateral arteriosclerosis" are common terms among middle-aged and elderly people, and both are essentially manifestations of systemic atherosclerosis in specific locations rather than independent diseases. Vertebrobasilar arteriosclerosis specifically refers to the hardening of the vertebral arteries and basilar arteries located at the back of the neck, which are responsible for supplying blood to the posterior part of the brain such as the brainstem and cerebellum; bilateral arteriosclerosis has a broader scope, which can refer to the hardening of bilateral carotid arteries, intracranial arteries or arteries in other parts of the body, with the core problem being that the arterial vessel walls gradually lose elasticity, thicken and harden, and even develop lipid plaques, leading to narrowing of the vessel lumen and impaired normal blood flow. The occurrence of such arteriosclerosis is not sudden but results from the long-term combined effect of multiple risk factors. The most core triggers are the "three highs"—hypertension can impact blood vessel walls for a long time and damage the vascular endothelium, hyperglycemia can impair the elastic fibers of blood vessels, and hyperlipidemia (especially elevated low-density lipoprotein cholesterol) can cause lipids to deposit on blood vessel walls and form plaques. In addition, aging is an inevitable factor with the incidence gradually increasing after the age of 40, and people with long-term smoking (nicotine constricts blood vessels and accelerates plaque formation), heavy drinking (damages vascular endothelium), obesity (especially abdominal obesity), lack of exercise, long-term staying up late, high mental stress, and a family history of arteriosclerosis also have a significantly higher risk of developing the disease.

 

In most cases, early arteriosclerosis may have no obvious symptoms, and many people are accidentally found during physical examinations such as carotid ultrasound, cranial CTA or MRA. However, as the disease progresses, if the degree of vascular stenosis worsens, symptoms will appear due to insufficient blood supply: if vertebrobasilar arteriosclerosis affects blood supply to the posterior brain, it may cause recurrent dizziness, vertigo (especially when turning the head), unsteady walking, blurred vision, tinnitus, and even transient loss of consciousness in severe cases; bilateral carotid or intracranial atherosclerosis may lead to insufficient blood supply to the anterior brain, manifested as memory loss, poor concentration, and numbness and weakness of limbs, and if plaques fall off and form blood clots, it may even induce cerebral infarction, leading to severe symptoms such as limb paralysis and slurred speech. After arteriosclerosis is detected, the core of treatment and intervention is to "control progression and prevent complications" rather than reverse the already formed hardening. First, it is necessary to strictly manage underlying diseases: hypertensive patients need to take antihypertensive drugs such as amlodipine and valsartan as prescribed by doctors to control blood pressure below 140/90 mmHg (lower for those with concurrent diabetes); diabetic patients use hypoglycemic drugs such as metformin and insulin to stabilize blood glucose within the target range; hyperlipidemic patients need to take statins such as atorvastatin and rosuvastatin to lower "bad cholesterol", stabilize vascular plaques and prevent plaque rupture. Second, it is essential to completely adjust the lifestyle: adhere to a low-salt (less than 5 grams per day), low-fat and low-sugar diet, eat more vegetables, fruits, whole grains and high-quality proteins such as fish, lean meat and soy products, and avoid fried and pickled foods; engage in at least 150 minutes of moderate-intensity exercise such as brisk walking, jogging and cycling every week and avoid prolonged sitting; strictly quit smoking, do not drink alcohol (or limit alcohol intake, with daily alcohol consumption ≤25 grams for men and ≤15 grams for women); ensure 7-8 hours of sleep and relieve mental stress through exercise, meditation and other methods.

 

From the perspective of prognosis, as long as arteriosclerosis is detected early and standardized intervention is persisted, the progression of arteriosclerosis in most patients will slow down significantly, no serious complications will occur, and normal life can still be maintained. However, if the condition is ignored and risk factors are not controlled, hardening will continue to worsen, and vascular stenosis may develop into occlusion, which in turn induces life-threatening diseases such as cerebral infarction and myocardial infarction. Therefore, it is recommended that people who have been found to have arteriosclerosis recheck their blood pressure, blood glucose and blood lipids every 3-6 months, and undergo carotid ultrasound or relevant vascular imaging examinations once a year to dynamically monitor vascular conditions. In short, arteriosclerosis is not an "incurable disease" but a "health reminder" from the body, and as long as active intervention is taken, risks can be effectively reduced and vascular health can be protected.