Harvard Heart Letter

Ask the doctor: Are some blood vessels more prone to blockages than others?

Ask the doctor

Are some blood vessels more prone to blockages than others?

Q. Are the coronary arteries more prone to developing blockages than arteries elsewhere in the body? When arteries from other parts of the body are used in bypass surgery, does their tendency to become blocked change?

A. The coronary arteries are, in fact, more prone to blockages than many other arteries in the human body. The main reason is that there is to-and-fro blood flow in the coronary arteries, as well as in the legs and the carotid arteries, two other regions prone to blockages. This turbulent blood flow hurts the lining of arteries, much like heavy winds blowing back and forth over time can take a toll on the trees in a forest. Where blood flow resembles a gentle breeze in one direction, as in your arms, blockages are less likely to occur.

One of the most fascinating examples of this is the aorta, the main artery of the body. It emerges from the heart pointed up toward the head, then arches downward, following the spine. Where the spine gently curves inward near the pelvis, the aorta curves, too, just before it splits into two branches, one for each leg. This curve and split create a region of disturbed blood flow that makes this stretch particularly vulnerable to atherosclerosis. In fact, this is where most abdominal aortic aneurysms form. Think of the curve in a river, and how driftwood or a canoe gets trapped in the eddies on one side while water on the other side scrapes the banks clean — that's like the blood flow in your lower aorta. So standing on two legs gave humans more lower aortic disease in addition to low back pain.

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