What causes carotid artery plaques, and can it be improved through active treatment?

After a friend found plaques in his carotid artery, he became very anxious, fearing that he would have a cerebral infarction one day. He asked Huazi what caused the carotid artery plaques. He is now actively treating and exercising. Can the plaques get better? Many articles on the Internet say that plaques cannot be eliminated after they are formed. Is this true?

Huazi comforted him by saying that judging from the formation mechanism of arterial plaques, it is difficult to eliminate plaques once they are formed. However, plaques in most people do not cause disease. Moreover, through active treatment, the progression of plaques can be slowed down, plaques can be reduced, and plaques in a small number of people can even be eliminated.

1. Causes of carotid artery plaques Carotid artery plaques are very common, and the incidence increases with age. More than half of the middle-aged and elderly people will have them. The incidence rate in men is three times that in women, and men develop plaques 10 years earlier than women on average.

This is because female estrogen can lower blood pressure and protect the cardiovascular system, and high blood pressure is the main cause of carotid artery plaques. In addition, obesity, hyperlipidemia, diabetes, smoking, lack of exercise and other factors are also common causes of carotid artery plaques.

2. The essence of atherosclerotic plaque is inflammatory reaction. The increased mechanical washing force of blood caused by high blood pressure, the stimulation of arterial intima by high blood lipids and high blood sugar, the toxic substances in tobacco and other factors will cause damage to the arterial intima, causing low-density lipoprotein cholesterol (LDL-C) in the blood to enter the arterial intima from the damaged area.

After entering the arterial intima, LDL-C is oxidized, generating inflammatory stimulation, inducing the body's macrophages to enter the arterial intima and engulf LDL-C. Macrophages that engulf too much LDL-C will transform into foam cells and deposit in the arterial intima. This process is repeated over and over again, and more and more foam cells are deposited, forming the lipid core of the atherosclerotic plaque, which is covered with a fibrous cap.

3. Most people have relatively stable carotid plaques. Atherosclerotic plaques are common, especially in narrow arteries and branches. Even healthy people without relevant risk factors may find plaques during physical examinations. Most of these plaques are stable plaques, with a small lipid core and thicker fiber caps. They contain more collagen fibers and smooth muscle cells, and progress slowly, with little impact on the body. You only need to observe regularly and maintain a healthy lifestyle, and no treatment is required.

However, a small number of people have plaques with a larger lipid core, thinner fiber cap, and fewer collagen fibers and smooth muscle cells. This type of plaque structure is unstable and is prone to rupture when blood pressure changes suddenly or when arteries contract or spasm, inducing platelet aggregation and then forming thrombi, causing disease. Such unstable plaques need to be treated.

Fourth, the key to treatment is to control blood lipids. The severity and stability of carotid plaques are mainly determined through carotid ultrasound observation and measurement of the thickness of the carotid intima and media. The goal of treatment is to slow down and reduce the thickening of the carotid intima and media, turning unstable plaques into stable plaques to reduce the probability of cerebral infarction.

After treatment, a few people can restore the thickness of the carotid intima and media to normal levels. But everyone should understand that the current medical level cannot completely eliminate foam cells, but it can increase their density and reduce the size of plaques, achieving a certain degree of reversal and "elimination".

The treatment of carotid artery plaque is mainly produced by regulating blood lipids. In particular, low-density lipoprotein cholesterol (LDL-C) is the most important indicator. Because no matter what factors cause damage to the arterial intima, it will eventually cause LDL-C to enter the arterial intima to form plaques. Therefore, as long as the level of LDL-C is controlled, the progression of plaques can be inhibited.

Relevant experiments have shown that when the LDL-C level in the blood drops to 2.0mmol/L, LDL-C will stop transferring to the arterial intima. When the LDL-C level in the blood drops below 1.8mmol/L, the LDL-C in the arterial intima will transfer back to the blood. Therefore, for people at high risk of cardiovascular and cerebrovascular diseases, doctors often require that LDL-C be controlled below 1.8mmol/L.

5. Healthy Lifestyle and Adherence to Medication To control blood lipids, you need to improve your diet and increase your exercise. Avoid eating high-cholesterol foods such as animal offal, fat, and margarine, and eat more high-fiber foods such as whole grains, whole grains, and vegetables. The amount of vegetable oil used in cooking should also be limited, preferably not more than 25 grams per day. At the same time, you should increase your exercise, with at least 30 minutes of moderate-intensity aerobic exercise per day, and strength training twice a week.

However, some people have dyslipidemia, and even with strict diet control and exercise, they cannot reach the target. In this case, they need to use lipid-lowering drugs under the guidance of a doctor. Statins are commonly used lipid-lowering drugs, which can not only lower blood lipids, but also have antioxidant and anti-inflammatory effects, improve arterial intima metabolism, and promote the transformation of unstable plaques into stable plaques. However, reversing plaques requires a long process, so a healthy lifestyle and medication require long-term persistence to see results.

In summary, if you find carotid artery plaques, don't be nervous. The doctor should determine the nature of the plaques. Only unstable plaques need treatment. Through active healthy living and treatment, plaques can be reduced and reversed, reducing the risk of disease. I am pharmacist Huazi. Welcome to follow me and share more health knowledge.