After a friend found a plaque in the carotid artery, the whole person became very anxious, fearing that he would get a cerebral infarction one day. He asked Hanako, what is the cause of carotid plaque formation, and now actively treat and exercise hard, can the plaque get better? Many articles on the Internet say that once there are plaques, they cannot be eliminated. Is it true?/You don't say.

Hanako comforted him that from the formation mechanism of arterial plaque, once it is formed, it is difficult to eliminate it. However, most people's plaques do not cause diseases. Moreover, through active treatment, we can slow down the progress of plaque, reduce plaque and eliminate plaque in a small number of people.

First, the cause of carotid plaque is a very common thing, and the incidence rate is increasing with age. Among middle-aged and elderly people, more than half will happen. The incidence rate of male is three times that of female, and the age of male plaque is earlier than that of female 10 years.

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

Second, the essence of atherosclerotic plaque is the increase of blood mechanical scouring force caused by inflammatory reaction and hypertension, the stimulation of hyperlipidemia and hyperglycemia on the intima of arteries, toxic substances in tobacco and other factors will damage the intima of arteries, and make low-density lipoprotein cholesterol (LDL-C) in blood enter the intima of arteries from the damaged area.

Thick LDL-C entering the intima of artery is oxidized to produce inflammatory stimulation, which induces macrophages in vivo to enter the intima of artery and devour LDL-C. Macrophages that devour too much LDL-C will be transformed into foam cells and deposited on the intima of artery. This process is repeated, and more and more foam cells are deposited, which constitute the lipid core of atherosclerotic plaque, which is covered with fiber cap.

Third, the carotid plaque in most people is relatively stable. Atherosclerotic plaques are common, especially in arterial stenosis and branches. Even healthy people without related risk factors may find plaques during physical examination. Most of these plaques are stable plaques with small lipid nuclei and thick fiber caps, among which there are many collagen fibers and smooth muscle cells, which progress slowly and have little impact on the body. You just need to observe regularly and maintain a healthy lifestyle without treatment.

However, a small number of people have larger fat nuclei, thinner fiber caps and fewer collagen fibers and smooth muscle cells. This kind of plaque has poor structural stability, and it is easy to rupture when blood pressure changes suddenly, or when arteries contract or spasm, which induces platelet aggregation, and then forms thrombosis and causes diseases. For this unstable plaque, treatment is needed.

Fourth, the key to treatment is to control blood lipid and judge the severity and stability of carotid plaque, mainly by observing the carotid artery with color Doppler ultrasound and measuring the intima-media thickness of the carotid artery. The goal of treatment is to slow down and reduce carotid intima-media thickening, turn unstable plaque into stable plaque, and reduce the probability of cerebral infarction.

After treatment, a few people can restore the carotid intima-media thickness to normal level. However, it should be understood that the current medical level can not completely eliminate foam cells, but it can increase their density, reduce the size of plaques, and achieve a certain degree of reversal and "elimination."

The treatment of carotid plaque is mainly through regulating blood lipid. Especially low density lipoprotein cholesterol (LDL-C) is the most important index. Because no matter what factors lead to arterial intima injury, LDL-C will eventually enter the arterial intima to form plaques. Therefore, as long as the level of LDL-C is controlled, the progress of plaque can be inhibited.

Related experiments show that when the level of LDL-C in blood drops to 2.0mmol/L, LDL-C will stop transferring to the intima of artery. When the level of LDL-C in blood drops below 65438 0.8 mmol/L, LDL-C in arterial intima will be transferred back to blood. Therefore, for the high-risk population of cardiovascular and cerebrovascular diseases, doctors often require LDL-C to be controlled below1.8 mmol/L.

5. Healthy living and insisting on drug control of blood lipid need to improve diet structure and increase exercise. Avoid eating high-cholesterol foods such as animal offal, fat and margarine, and eat more high-fiber foods such as coarse grains, miscellaneous grains and vegetables. Vegetable oil for cooking should also be limited, not exceeding 25 grams per day. At the same time, we should increase the amount of exercise, not less than 30 minutes of moderate-intensity aerobic exercise every day, and do strength exercises twice a week.

However, some people have dyslipidemia, and even if they strictly control their diet and exercise, they can't reach the standard. At this time, it is necessary to use lipid-lowering drugs under the guidance of a doctor. Statins are commonly used lipid-lowering drugs, which can not only reduce blood lipid, but also have the effects of anti-oxidation, anti-inflammatory reaction, improving intimal metabolism, and promoting the transformation of unstable plaque into stable plaque. But it takes a long time to reverse the plaque, so a healthy lifestyle and drug treatment need long-term persistence to see the effect.

To sum up, there is no need to be nervous when finding carotid plaque. The nature of plaque is judged by doctors, and unstable plaque needs treatment.