Is it dangerous to have soft plaques in the carotid artery? How can I eliminate them?

A friend left a message to Huazi, saying that he had found soft plaques in his carotid artery. Was there a risk of cerebral infarction? Was there any way to eliminate it? Huazi told him that most carotid artery plaques are not dangerous in themselves, but usually just serve as a "window" of the human artery, reflecting the condition of other arteries in the human body.

Once carotid artery plaque appears, it is difficult to completely eliminate it. However, the use of lipid-lowering drugs, mainly statins, and strict control of low-density lipoprotein cholesterol (LDL-C) levels may reverse the plaque.

1. Carotid arteries are prone to plaques

The carotid artery in the human body is a place where plaques are very likely to form. Because the artery has a "branch", the shear force changes when blood flows through it, which can easily cause mechanical damage to the carotid artery intima. The LDL-C in the blood will invade the damaged arterial intima and then form atherosclerotic plaques.

In fact, color Doppler ultrasound examination cannot directly "see" plaques, but through the feedback of ultrasound, by measuring the thickness of the carotid artery intima. The two multiplied numbers on the carotid artery color Doppler ultrasound report refer to the long diameter and short diameter of the plaque. The true danger of the plaque depends on its thickness and the degree of stenosis of the carotid artery.

If it is just a flat plaque and there is no carotid artery stenosis, it means the situation is not serious and there is no big problem.

2. Dangers of Carotid Artery Plaque

Carotid artery plaques are related to age. The older you are, the greater the probability of plaques. Among people over 50 or 60 years old, more than half of them will have carotid artery plaques.

For most people, carotid artery plaques are not very dangerous. Among patients with cerebral infarction, only a very small number are caused by carotid artery problems. The vast majority are caused by atherosclerosis of the cerebral arteries and atrial fibrillation.

The presence of plaques in the carotid arteries does not mean that plaques will also appear in the cerebral arteries. The vast majority of people can coexist with carotid artery plaques without developing disease.

3. What situations require intervention?

Under the influence of risk factors such as hypertension, hyperlipidemia, diabetes, smoking, and obesity, the progression of plaques will accelerate, and plaques may also appear in cerebral arteries at the same time. Under the influence of risk factors, the nature of plaques is also more unstable and prone to rupture, which will induce platelet aggregation and form thrombus.

If the plaque test result is "strong echo" or "isoechoic", it means that the plaque is uniform and stable. If there are no related risk factors, drug intervention is not necessarily required. If the test result is "low echo" or "mixed echo" and other unstable soft plaques, and there are risk factors such as "three highs" and smoking, timely intervention is required.

Statins can reverse plaques

The lipid core of the plaque is composed of a large number of foam cells containing LDL-C. These cells cannot be completely removed, so the plaque cannot be eliminated. However, the use of statins can increase the density of the lipid core of the plaque, reduce its volume, make it less likely to rupture, and play a role in reversing the plaque.

There are two prerequisites for reversing plaques. The first is that LDL-C must meet the standard. For people who have not had myocardial infarction or cerebral infarction, LDL-C must be reduced to below 2.6mmol/L; for people who have had myocardial infarction or cerebral infarction, LDL-C must be reduced to below 1.8mmol/L.

The second condition is to persist in taking the medication long enough. It usually takes 2 to 4 years of continuous medication to achieve the effect of reversing plaques. For those who have no contraindications to the medication, it is recommended to take it for life.

In summary, the vast majority of carotid plaques are not dangerous, so don't panic. As long as you improve your healthy lifestyle, use medication under the guidance of a doctor to control the "three highs", and use statins to bring LDL-C up to standard, it is still possible to reverse the plaque and reduce the risk. 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.