A friend told Huazi that he was diagnosed with carotid artery plaque, but his blood pressure, blood sugar and blood lipids were all within normal range. Why did he still have plaques? Should he take statins now?

Huazi told him that he didn't need to rush to take statins because the occurrence of plaques is highly correlated with age and is almost impossible to avoid. Although taking statins can bring benefits, it also brings the risk of adverse reactions. If the risk of the disease is not very high, using statins may not be worth the cost.

1. Almost unavoidable plaques

The incidence of carotid artery plaques is related to age . Among people over 45 years old, the incidence of plaques gradually increases with age. Among people in their 70s and 80s, only a very small number of people do not have plaques. Therefore, plaques, like wrinkles on the skin, are a sign of aging that most people cannot avoid .

During adolescence, many people's arterial lining will form "fatty streaks", which will gradually progress into atherosclerotic plaques in middle age as they age.

Plaques usually progress slowly, and it often takes decades from the discovery of plaque formation to the narrowing of arteries and even the induction of blood clots. And the current life expectancy of humans is only a few decades, which means that the natural progression of plaques will hardly affect life expectancy.

2. The progression of plaques will accelerate

However, the progression of plaques is affected by many factors, including high blood pressure, high blood lipids, high blood sugar, smoking, lack of exercise, genetics, etc., which can accelerate the progression of plaques . Therefore, before reaching the expected life span, plaques may progress to a point that threatens health, so we need to control the three highs, quit smoking and exercise more.

The danger of a plaque depends not only on its size, but more importantly on whether it is stable .

Larger plaques can cause arterial narrowing and affect blood supply to organs, but this can be reversed through drug treatment, and symptoms can also be relieved through surgeries such as stents, balloons, and bypass surgeries.

Unstable plaques are prone to rupture , which can induce thrombosis, cause serious diseases such as myocardial infarction and cerebral infarction, and pose a threat to life.

3. Do I need to use statins if I have plaques?

Statins can increase the stability of plaques, reduce the possibility of rupture, and have a good preventive effect on myocardial infarction and cerebral infarction. However, taking statins may affect liver function, damage muscles, or increase blood sugar. It may also cause gastrointestinal irritation and sleep disorders, affecting the quality of life, so it is necessary to evaluate whether the medication can bring greater benefits .

For patients with small and stable plaques, and who do not have other cardiovascular risk factors such as high cholesterol, high blood sugar, and high blood pressure, smoking, etc., statins may not be used temporarily. However, regular follow-up examinations should be performed, and the progression of plaques should be monitored by carotid ultrasound.

If it is an unstable large plaque, or is accompanied by three highs, a history of smoking, or the degree of arterial stenosis exceeds 50%, or cerebral infarction, myocardial infarction and other diseases have occurred, it is recommended to use statins for treatment.

Through carotid artery ultrasound , the size, thickness, stability, etc. of plaques can be determined; through CTA examination , the risk of plaques can be further assessed. Although some plaques are small in size, they may be irregular in shape, rich in lipids, with protrusions or ulcers on the surface, and they also have greater risks, so it is recommended that those who have the conditions should undergo a detailed examination.

In summary, carotid artery plaques are mainly related to age, but the rate of progression is affected by multiple factors. Smaller stable plaques are safer and statins may not be used for the time being; larger unstable plaques are more risky and statins are needed to reduce the risk of disease.

Drugs must be used under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.