Uncle Wang is 67 years old this year and has a history of hypertension for over 10 years. This year's physical examination revealed plaques in Uncle Wang's carotid artery and an increase in low-density lipoprotein. Because he was worried that the plaque would grow larger and potentially cause blood clots, Uncle Wang inquired around to see if there were any methods to "eliminate" the plaque.

A friend told him that statins are very effective in treating carotid plaques. Uncle Wang thought his friend was reliable, so he went to a nearby pharmacy to buy statins recommended by his friend.

In order to make the plaque disappear quickly, Uncle Wang has been taking medication regularly, but his dietary habits have not changed much. He still smokes and drinks with old friends, and occasionally stays up all night playing cards

One year later, Uncle Wang re examined and found that the plaque had not shrunk at all. The ultrasound showed that the plaque still existed. Uncle Wang thinks that his friend may have "tricked him" by taking medicine for nothing.

1、 Is taking statins really effective if there are carotid plaques in the body?

According to a prospective study published in the Chinese Journal of Circulation, one-third of adults in China have carotid atherosclerotic plaques. Further investigation has found that almost everyone over the age of 60 has carotid artery plaques.

Many people, after discovering carotid artery plaques in their bodies, will go to the pharmacy to buy statins to take, trying to make the plaques shrink or "disappear". So why do some people take them but it doesn't work?

Carotid artery plaque is a manifestation of carotid atherosclerosis. From the naked eye, it is a white or yellow oval shaped bulge in the intima of the artery. Clinically, it can be divided into stable plaque and vulnerable plaque, with vulnerable plaque in the majority.

There are many reasons for carotid plaque, including hyperlipidemia, hyperhomocysteinemia, hypertension, hyperuricemia, smoking, metabolic syndrome, diabetes, hypertriglyceridemia, etc.

Can taking statins on carotid plaques make them disappear? Unfortunately, plaque formation is easy, but reversing it is very difficult.

The main mechanism of action of statins is to inhibit the synthesis of cholesterol in the liver, reduce one of the raw materials for plaque formation, and slow down the growth rate of plaques. But the composition of plaques also includes triglycerides, low-density lipoprotein, and other raw materials, which cannot be broken down by statin drugs.

But studies have shown that taking statins can help stabilize plaques and reduce the risk of cardiovascular events by 20% to 25%. That is to say, long-term use of statins can still benefit the body.

It should be noted that not everyone can take statins. Whether statin intervention is needed should be judged based on whether the following conditions are met:

1. Diagnosed with coronary heart disease or ischemic stroke, regardless of whether there is significant stenosis in the carotid artery, immediate statin treatment should be received;

2. No coronary heart disease and ischemic stroke, but with diabetes and hypertension;

3. Diabetes patients aged ≥ 40 years, and LDL-C>2.6 mmol/L;

4. Chronic kidney disease (stage III or IV) with LDL-C>2.6mmol/L;

5. The presence of hypertension or other risk factors, and LDL-C>3.4 mmol/L.

2、 How far is it from cerebral infarction if carotid artery plaque is detected?

The appearance of plaques indicates arteriosclerosis. In the early stages of the disease, patients may not have obvious feelings, but as the plaques gradually grow larger, exceeding 50% of the vascular lumen, blood flow will be obstructed, making it easy for plaques to fall off and form blood clots, thus facing the following two consequences:

Fragmented debris can float into the brain through the blood, leading to ischemia or necrosis of some brain tissue, causing dizziness, blurred vision, and affecting movement in patients;

The blood vessels blocked by debris are thicker and affect blood supply, which can lead to cerebral infarction or stroke. Patients may experience dizziness, fainting, hemiplegia, and abnormalities in one side of the body.

Especially some bad habits can accelerate the "growth" of plaques:

1. Excessive pressure

In the state of high pressure for a long time, the biological clock of human will also be affected, and the sympathetic nerve will be excited for a long time, which will lead to the exuberant secretion of adrenaline in the body, the increase of blood pressure and blood sugar, thus accelerating the process of atherosclerosis.

2. Long term smoking

People who frequently smoke contain harmful substances in their blood vessels, which can cause damage to the blood vessel wall and increase the accumulation of cholesterol, accelerating plaque production.

3. Long term staying up late

A study published in Nature found that insufficient sleep can increase inflammatory cells, which is the main cause of atherosclerosis.

4. Long term sitting for extended periods of time

Sitting still for a long time can affect the flow rate of blood circulation, leading to an increase in blood viscosity and eventually causing arteriosclerosis in the body.

5. Chronic diseases, obesity

Hypertension patients and diabetes patients are high-risk groups of atherosclerosis, and these groups should pay more attention to the stability of plaque control.

When the body experiences brief aphasia, motor dysfunction, and transient blurred vision, it is likely to indicate that the plaque is at high risk. Early intervention is recommended, preferably within two weeks, to seek relevant treatment from a doctor.

3、 Can vascular plaques shrink? Doing 4 things well may lead to successful intervention

Can't the 'plaques' in the blood vessels disappear? In fact, it is not possible to reverse or even regress arterial stenosis by actively intervening when it does not exceed 50%. What should we do specifically?

Actively intervening in risk factors

The formation of carotid plaques can be divided into controllable and uncontrollable factors, among which high-risk factors such as high uric acid, hypertension, hyperlipidemia, and hyperhomocysteinemia can be adjusted in a timely manner through lifestyle interventions.

By cooperating with treatment and supplementing with folic acid, positive intervention can be achieved.

Correcting unhealthy lifestyles

To avoid plaque formation, we need to protect our blood vessels, quit smoking and drinking, have a healthy diet, exercise regularly, and avoid staying up late to maintain a positive attitude.

Persist in medication treatment

Statins cannot inhibit cholesterol synthesis, maintain plaque stability, and are the basic medication for regulating blood lipids. In addition, when the plaque ruptures, antiplatelet drugs can be used to avoid activating fibrin and prevent thrombosis.

Strengthen blood lipid management

The core of plaques is lipids, and one of the key to reversing plaques is to strengthen lipid-lowering and strictly control cholesterol levels.

Research has shown that controlling low-density lipoprotein cholesterol below 2.0 mmol/L can halt the growth of most plaques; After being controlled at 1.5mmol/L, most plaques showed a trend of shrinking.

The risk of plaques has a lag effect. When plaques are discovered, it is important to follow the doctor's advice, actively cooperate with medication, undergo regular check ups, and receive lifestyle interventions to control the condition. Only then can multiple aspects of control be achieved and the possibility of plaque reversal be realized.