Red blood cell aggregation and atherosclerosis: Curvilinear clinical implications

The progression of atherosclerosis is closely associated with red blood cell (RBC) aggregation. By increasing blood viscosity and reducing shear stress, RBC aggregation induces blood flow stasis and microcirculatory dysfunction, thereby facilitating lipid deposition within the vascular wall. Moreover, aggregated RBCs activate endothelial inflammatory responses and trigger oxidative stress, forming a pathological cycle characterized by "aggregation-inflammation-oxidation." The red blood cell aggregation index (EAI) correlates with the severity of atherosclerosis and may serve as a potential biomarker for early diagnosis. In integrative Chinese and Western medical approaches, blood-activating and stasis-resolving traditional Chinese medicines exhibit multitarget regulatory effects, particularly in improving hemorheological properties and suppressing inflammation, providing novel insights into the prevention and treatment of atherosclerosis.