[동아일보] 딱딱한 핏줄은 만병원인... 당뇨병처럼 평소 관리해야
                    - 심장내과 이병권교수,내분비내과 강신애교수

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[건강 100세, 문제는 혈관]<상>동맥경화를 막아라

《 최근 기온이 갑자기 떨어지면서 심장동맥이 막히는 심근경색이나 뇌중풍(뇌졸중) 등 혈관 관련 환자들이 늘고 있다. 혈관이 막히거나 좁아지거나 찢어지는 등의 혈관 문제가 생기면 생명과 직결될 수 있으므로 평소 관리와 예방이 중요하다. 본보와 강남세브란스병원은 ‘건강 100세, 문제는 혈관’이라는 3회 시리즈를 통해 혈관 건강법을 제시한다. 》

우리 몸의 혈관 길이는 무려 10만여 km. 지구 둘레의 2바퀴 반 길이다. 이 긴 혈관의 문제는 ‘탄력성’을 잃는 데서 시작된다. 매 순간 심장이 힘차게 뿜는 혈액은 속도와 연관돼 혈관 안 압력을 증가시킨다. 이 혈압을 일정하게 유지하고 혈액을 몸 구석구석에 보내기 위해 혈관은 몇 겹의 탄력 있는 층으로 이뤄져 있다. 심장이 뿜는 리듬에 맞춰 혈관의 굵기가 늘거나 줄면서 우리 몸에 골고루 산소와 영양분을 공급한다.

하지만 혈관이 딱딱해지는 동맥경화가 오면 혈압을 견디지 못해 동맥혈관이 터지거나 온몸 곳곳에 혈액을 보내지 못하는 허혈현상이 생긴다. 심장질환의 국내 전문가인 이병권 강남세브란스병원 심장내과 교수와 당뇨병 전문가인 강신애 내분비내과 교수의 도움말로 혈관을 젊게 유지하는 방법을 알아본다.


○ 혈관 건강 악화의 주범은

노화와 고혈압은 혈관을 딱딱하게 만드는 직접적 요인으로 꼽힌다. 또 당뇨병 흡연 고지혈증은 혈관 내부에 노폐물을 축적시키고 혈관조직에 상처를 내 과자처럼 쉽게 부서질 만큼 변성시키는 ‘죽상동맥경화증’을 가져오기도 한다. 이 중 당뇨병은 혈관 건강에 가장 악영향을 주는 질환이다.


사용자 삽입 이미지


강 교수는 “당뇨병과 고지혈증을 비롯한 대사증후군은 혈관 내부에 만성 염증반응을 일으켜 혈관을 딱딱하게 만든다”며 “특히 콜레스테롤은 혈관 내 염증세포를 자극해 혈관 경화를 더욱 악화시킨다”고 말했다. 이 때문에 당뇨병 환자의 심혈관 질환 발병 위험률은 일반인에 비해 남성은 3배, 여성은 4배나 높다.

따라서 당뇨병을 치료하고 예방하는 것은 사망 원인질환 1위인 심혈관 질환의 혈관 합병증을 치료하고 예방하는 것과 같다고 보면 된다.

혈관이 오래도록 탄력을 유지할 수 있게 미리 대처하는 법은 없을까. 안타깝게도 혈관질환은 서서히 진행돼 초기 증상이 없다. 따라서 △고혈압으로 진단받거나 △운동할 때 금세 지치고 숨차거나 어지럼증과 두통 등을 느끼면 이미 병이 상당히 진행된 상태이므로 예방이 최선이다.

이 교수는 “흡연과 고지혈증, 당뇨, 비만, 가족력 등 위험요소를 많이 지니고 있다면 동맥경화 발병이 더욱 빨라지므로 생활습관 교정과 함께 혈압 혈당 콜레스테롤 체지방률 동맥경화도(맥파 속도) 검사를 통한 조기치료가 꼭 필요하다”고 말했다. 평소 저염식, 저콜레스테롤 식사, 소식, 일주일에 3∼4회 정도의 규칙적 유산소 운동, 체중관리 등을 하는 정도면 충분히 혈관을 탄력적으로 만들 수 있다.

또 남성은 45세 이상, 여성은 폐경 이후 1∼2년에 한 번씩 정기검진을 해야 하고 위험 요소를 많이 지닌 고위험군은 해마다 전문의 상담이 필요하다. 특히 동맥경화를 동반한 당뇨병 환자들은 원인질환인 당뇨병와 고혈압 그리고 혈액 속 나쁜 콜레스테롤 수치를 낮추는 세 가지를 잘 치료해야 혈관 합병증을 예방할 수 있다. 물론 본인의 생활습관 개선 의지가 가장 중요하다.

이 교수는 “남보다 혈관 나이가 젊다거나 더 늙었다거나 하는 말을 듣는다면 그만큼 혈관건강을 위해 정기 검진과 좋은 습관을 갖도록 노력을 했느냐 하지 않았느냐의 차이로 보면 된다”고 말했다.


○ 혈관 건강 식품의 허와 실

동맥경화는 대표적인 만성 퇴행성 질환인데도 시중에 나와 있는 각종 기능성식품과 영양제의 선전효과를 그대로 믿어 이를 많이 먹기만 하고 정기 검진이나 올바른 생활습관으로 관리를 하지 않으면 되레 큰 병을 만들 수 있다.

강 교수는 “혈당에 좋다는 기능성 식품 중에 약간의 혈당 강하에 효과를 보이는 것이 있는지는 모르겠지만 당뇨병의 궁극적인 치료 목표인 혈관 합병증을 치료하고 예방하는 효과는 어느 것도 증명된 바 없다”며 “전문의가 처방하는 안정성과 치료효과가 입증된 약물과 올바른 생활습관으로 교정하는 것만이 가장 빠르고 효과적인 치료법”이라고 조언했다.

과대 포장돼 2010년 식품의약품안전처로부터 적발된 당뇨 관련 건강 보조식품으로는 녹심 당스탑, 솔고 자라분말 등이 있다. 또 각종 효소, 돼지감자 등도 과대 포장된 식품으로 지목된다. 효소는 설탕에 절인 상태인 것이 대부분이어서 많은 양을 장기 복용하면 효소에 포함된 당 성분 때문에 혈당이 상승한다. 돼지감자도 흰 쌀밥이나 설탕 음료를 많이 먹는 것보다는 좋다. 하지만 당뇨에 좋다고 알려진 점만 믿고 너무 많이 복용하면 감자의 탄수화물이 체내에 들어가서 포도당으로 바뀌고 혈당을 높이게 된다. 결국 어떤 건강 보조식품도 너무 많은 양을 장기 복용하는 일은 자제해야 한다.

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