Mr. Zhang: I don't have hypertension or diabetes. Why do I have carotid plaque?

Doctor: Carotid plaque is the manifestation of vascular atherosclerosis. Atherosclerosis is an inflammatory reaction caused by a large amount of fat deposition in vascular endothelium after injury, and fatty degeneration results in lipid accumulation in subclavian atherosclerosis. When atherosclerotic lipids aggregate, plaques are formed.

Therefore, the formation of plaque will go through several stages, such as vascular endothelial injury, fat deposition, fat inflammatory reaction, aggregation and so on, and vascular endothelial injury is the basis of its occurrence. There are many reasons for endothelial injury, such as elevated blood pressure and blood sugar, which are caused by the body's own diseases; Besides, there are many other factors, such as smoking, drinking and staying up late. And the aging and aging of blood vessels with age. Therefore, it is not only people with high blood pressure and diabetes who will have plaques.

Mr. Zhang: So carotid plaque is inevitable?

Doctor: Of course not. For example, the blood vessels of the elderly will age, which is called arteriosclerosis. Its essential difference from atherosclerosis is that there is no fat deposition and the formation of atherosclerotic lipid substances. These substances are equivalent to "impurities" in the blood vessel wall, just like products are defective, which are inferior. Such blood vessels are the pathological basis of cardiovascular and cerebrovascular diseases. Therefore, atherosclerosis can also be avoided, and taking effective intervention measures from any link of atherosclerosis and plaque formation will help to prevent these diseases.

Zhang: Can the plaque already formed be reduced or eliminated?

Doctor: the formation of plaque has a gradual process, such as from small to large, which shows that the factors leading to plaque formation have always existed; For example, from soft to hard, at first it was just fat deposition. Deposition for a long time will cause inflammatory reaction and lead to fatty degeneration. At this time, it is called soft spot, and the soft spot becomes hard spot after calcification or fibrosis. When the plaque is in the stage of fat deposition, fat can be removed to reduce or eliminate the plaque. When it is in the soft plaque stage, it is unlikely to eliminate denatured fat, but it is impossible to eliminate hard plaque. However, no matter what kind of plaque, timely intervention and treatment measures can prevent and delay the continued progress of plaque and have a positive effect on reducing plaque.

Mr. Zhang: How to treat it? Are you taking lipid-lowering drugs? How long will it take?

Doctor: The prevention and treatment of arterial plaque needs comprehensive measures. The most basic thing is to remove the risk factors that damage vascular endothelium. Patients with diabetes and hypertension should also control blood sugar and blood pressure, quit smoking and drinking, live a regular life and don't stay up late. Reducing blood lipid can effectively avoid fat deposition and play a very important role in the prevention and treatment of arterial plaque.

People with atherosclerosis and plaque often need to take statins to lower the level of low-density lipoprotein in blood lipids. The main function of low-density lipoprotein is to transport fat to vascular endothelium, which reduces the "transport vehicle" for transporting fat and greatly reduces the chance of fat deposition. Moreover, these drugs can also inhibit the inflammatory reaction of fat, prevent it from denaturation and lipidation, not only reduce plaque, but also provide opportunities and possibilities for removing deposited fat.

Because people with atherosclerosis and plaque have much higher requirements for controlling low-density lipoprotein than ordinary people, they usually need statins to help them achieve it, so they need to take it for a long time. Once they stop using it, low-density lipoprotein will rise rapidly, which will increase the risk of vascular disease again.

As for the damage caused by long-term medication that many people are worried about, although the drug has certain side effects and adverse reactions, its harm is negligible compared with atherosclerosis and plaque formation. Therefore, as long as the benefits of long-term medication far outweigh the adverse reactions, you should stick to taking it and never stop taking it without authorization.

Mr. Zhang: Can carotid plaque block blood vessels?

Doctor: First of all, I would like to remind you that carotid plaque is only a window of systemic vascular diseases. Carotid plaque suggests that other parts of the body may have the same lesions, which should be paid enough attention to. Secondly, plaque is a kind of mass protruding from the inner surface of blood vessels, which will lead to vascular stenosis. When the plaque grows to a certain extent, it will of course block blood flow and block blood vessels. For such a large plaque, there are ways to remove the blockage by surgical peeling off the plaque, and there are also ways to treat it. The most dangerous thing is the blockage caused by plaque rupture.

Plaque may rupture under the action of factors such as sudden increase of blood pressure and sharp increase of blood sugar. After rupture, the atherosclerotic lipids in it will be exposed to the blood, resulting in a large number of platelets gathering to form thrombus, which can block any blood vessel in the whole body with blood flow at a very fast speed. When the plaque will rupture is unpredictable, and danger may occur at any time, which is the focus of prevention.

Zhang: How to prevent thrombosis?

Doctor: The factors of plaque formation mentioned above are also the inducement of plaque rupture, so the treatment of atherosclerosis and plaque is the most important preventive measure. At the same time, some people will also take anticoagulants that inhibit platelet aggregation to prevent thrombosis.

In a word, the formation of carotid plaque shows that there are risk factors causing atherosclerosis in blood vessels, and it must not be ignored to find out the reasons and take corresponding intervention and treatment measures. Know that the body is our own, and it will treat you as you treat it.

# Breeze Project #

# Health Truth Agency #

Color Doppler ultrasound of carotid plaque was mixed echo last year and strong echo this year. Is it good or bad?