If there is plaque in the carotid artery, why do we need to use aspirin? What is the significance?

A friend told Huazi that he had found plaques in his carotid artery, which was 50% narrowed, and the doctor told him to take aspirin. He read Huazi's previous article, which said that aspirin only inhibits platelet aggregation and has no therapeutic effect on plaques themselves. Is this medication considered overtreatment?

Huazi said that the stenosis of his carotid artery has exceeded 50%, and the risk of cardiovascular and cerebrovascular diseases is still relatively high. In this case, using aspirin is not considered overtreatment.

1. Dangers of carotid artery plaques The carotid artery is close to the aorta, bears high blood pressure, and has "Y"-shaped branches, which makes it easy for atherosclerotic plaques to appear. In addition, the carotid artery is the closest large artery to the body surface and is easy to detect with ultrasound, so it is often used as a "window" to detect the whole body arterial system.

Most of the carotid arteries are flat plaques, which are usually caused by mechanical scouring of blood flow and are not very dangerous. As long as blood pressure, blood lipids and blood sugar are controlled, smoking is stopped, a healthy diet and regular exercise are performed, the occurrence of the disease can be prevented without the use of aspirin.

2. What is the role of aspirin? The truly dangerous plaques in the carotid artery are the plaques that cause carotid artery stenosis. If the carotid artery stenosis exceeds 50%, it is inherently unstable and means that the cerebral artery may also have severe atherosclerosis, with unstable plaques that may rupture, activate platelet aggregation to form thrombi, block cerebral blood vessels, and cause cerebral infarction.

The role of aspirin is to combine with cyclooxygenase in platelets, producing an irreversible inhibitory effect and preventing platelet aggregation. Therefore, aspirin is a "firefighter" on standby at all times, ready to put out the "fire" of thrombosis at any time.

3. Aspirin is not a "magic drug" Although aspirin is very important, we must clearly understand that aspirin is not a "magic drug". When using aspirin, it may also cause digestive tract damage and increase the risk of bleeding. It can only be used when the benefits of using the drug far outweigh the risks.

For example, if the carotid artery stenosis exceeds 50%, or if you have coronary heart disease, or if you have had a stroke or myocardial infarction, you must use aspirin for antiplatelet therapy. If you cannot tolerate the adverse reactions of aspirin, you also need to use other antiplatelet drugs to replace the effect of aspirin. However, if you do not have a high risk of cardiovascular and cerebrovascular disease, aspirin is not recommended.

4. Treating the plaque itself is more important. The role of aspirin is only to prevent the occurrence of thrombosis when the plaque ruptures. But the best way is to prevent the plaque from rupturing. Now medical evidence shows that statins can prevent plaque rupture. And so far, no other drug can replace the effect of statins on plaques.

The pharmacological action of statins is to reduce the synthesis of cholesterol, thus removing the fuel from the plaque and preventing it from progressing. At the same time, they can increase the metabolism of the arterial lining, produce anti-inflammatory and antioxidant effects, reduce the size of the plaque, increase its density, and transform it from an unstable plaque to a stable plaque, making it less likely to rupture.

Therefore, for the treatment of carotid artery plaques with a higher risk, statins and aspirin must be used at the same time. For plaques with a lower risk, it is only necessary to control the underlying disease and use statins.

To summarize, if plaques are found in the carotid artery, it is not necessary to take aspirin. The decision on whether to use medication depends on how great the risk of cardiovascular and cerebrovascular diseases is. The risk assessment of the disease needs to be evaluated by a doctor. Generally speaking, when the degree of arterial stenosis exceeds 50%, or when a person has already suffered from coronary heart disease, cerebral infarction, or myocardial infarction, the risk is greater and medication is needed. If you have any questions about medication, consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and share more health knowledge.