How can we reduce arterial stenosis? Can lowering blood lipids reduce the size of atherosclerotic plaques?

Many people ask Huazi the same question: If the arteries are atherosclerotic and become narrow, what can be done to reduce the narrowing of the arteries? Huazi said that with the current medical level, using statins to lower blood lipids is the only way to reduce atherosclerotic plaques, but for most people, it is very difficult to reverse the plaques. As long as the plaques can be controlled from getting worse, it is a great victory.

1. It takes decades for arterial plaques to grow Most people are surprised when they first discover plaques in their arteries. When did the plaques grow and why did they not feel anything at all? This is because atherosclerosis is not formed overnight. In many people's teenage years, cholesterol begins to enter the arterial intima and deposit in it, forming "fatty streaks."

As we age, cholesterol deposits in the arterial lining increase, and the "fatty streaks" will turn into atherosclerotic plaques. But this process is very long, usually taking decades to occur. Generally speaking, the growth of plaques themselves is very slow, and it takes decades from the discovery of plaques to causing severe narrowing of the arteries.

However, factors such as high blood pressure, high blood lipids, high blood sugar, and smoking will accelerate the growth of plaques.

2. Once the plaque is formed, it cannot be completely removed Many people have asked Huazi how to "dissolve" the plaque in the blood vessels? Unfortunately, with current medical technology, there is no way to remove atherosclerotic plaques. Because when cholesterol enters the arterial intima, it will be swallowed by macrophages, but it cannot be digested. Eventually, the macrophages "filled with" cholesterol will transform into foam cells and deposit in the arterial intima.

If you cut open the plaque, you will see many yellowish granular foam cells, just like millet porridge, which is also the origin of the name of "porridge-like" plaque. However, the process of macrophages transforming into foam cells is irreversible, and foam cells have no mobility, which means that once plaques in the arteries are formed, there is no way to remove them.

3. But some people's plaques can be reversed. Plaques cannot be removed, so why can some people have a reversal effect after treatment, reducing the degree of arterial stenosis? This is because plaques cannot be removed, but the density of plaques can be increased and the volume of plaques can be reduced, thus producing a "reversal" effect of plaques.

When performing color Doppler ultrasound examination of the arteries, the degree of arterial stenosis is estimated by the thickening of the arterial intima. When the volume of atherosclerotic plaques decreases, the arterial intima will become thinner. Although the plaques still exist in the arterial intima, the arterial stenosis will be alleviated.

4. It is good to maintain the plaque from getting worse. It is not easy to reverse the plaque and reduce the narrowing of the artery. A lower blood lipid level is required, usually measured by the low-density lipoprotein cholesterol (LDL-C) level. The LDL-C level must be at least below 2.6mmol/L for plaque reversal to occur.

Generally speaking, when LDL-C is less than 1.8mmol/L, there will be a better effect of reversing plaques. Some people even need to reduce their LDL-C level to below 1.4mmol/L. And after the LDL-C level reaches the standard, it must be maintained for at least 6 months. It usually takes 2 to 4 years for plaque reversal to occur.

The danger of atherosclerotic plaques is that unstable plaques rupture, inducing platelet aggregation to form thrombi. However, "soft plaques" with low density, large volume and high instability are more likely to reverse. After the density increases, the stability will increase, preventing rupture.

However, it is more difficult to reverse the "hard plaques" with higher density and smaller volume. Most people's plaques are not very large. The purpose of taking statins to control blood lipids is just to prevent the plaques from getting worse and to increase the stability of the plaques, which is a great victory in the fight against the disease.

To sum up, arterial stenosis caused by atherosclerosis can be reversed by taking statins to lower LDL-C levels, which can reduce the degree of stenosis. However, the reversal of plaques is also subject to a variety of conditions. For most people, as long as the plaques can be stabilized and no longer worsen, it is a great victory. 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.