Is carotid plaque really irreversible? Why did the plaque a few years ago disappear now?

Someone asked Huazi that he had found carotid plaque a few years ago, but the plaque had disappeared during a recent examination. Didn't it mean that arterial plaques cannot be reversed, so where did his plaques go? Huazi said, congratulations on his luck, the cases of plaque reversal and disappearance are very rare. Because of the principle of atherosclerosis, once the atherosclerotic plaque in the artery appears, it can only slow down or stop its growth, and it is almost irreversible. However, in the literature, it is true that there are cases of carotid plaque disappearing, but it is very rare.

1. Carotid artery endothelial injury: The blood ejected from the human heart is under high pressure, and a "strong" pipeline is needed to transport it safely. The human artery is such a "high-pressure" pipeline. In order to transport blood safely, the arterial endothelium is very dense and smooth, and the components in the blood usually cannot penetrate the arterial endothelium.

The carotid artery of the human body has a "Y"-shaped fork, and the rushing blood is divided into two streams. The arteries here are like a "watershed" and must withstand the constant washing of blood. Over time, the endothelium of the carotid artery will be mechanically damaged, and cholesterol in the blood will take the opportunity to invade the endothelium of the artery from the damaged place.

2. Macrophages become "dead fat people": cholesterol in the blood is a normal nutrient component of the human body, but when it enters the endothelium of the moving tube, it will produce reactions such as oxidation and inflammatory stimulation, and become "disruptive molecules" ", the body will send macrophages to deal with them. The way macrophages deal with cholesterol is very simple and rude, that is, "eat".

Macrophages eat cholesterol into their stomachs, and a small amount of cholesterol will be "digested" by the biological enzymes in the cells. However, if the macrophages eat too much cholesterol, they cannot digest it all. As a result, the macrophages became fatter and fatter, until they finally stretched themselves to death and became a "dead fat man", that is, transformed into foam cells. Many foam cells are deposited together to become the lipid core of atherosclerotic plaque, and carotid plaque is formed.

3. It is easy to ask God to send God away, but macrophages can move freely between tissues to eliminate substances harmful to the human body. But when the body invites it in to deal with cholesterol, it may not be able to send it away. Because when it is transformed into a foam cell, it loses the ability to move, and can only settle down in place, becoming a "dead fat man" who dominates one side.

"Dead fat people" live in the endothelium of blood vessels, which will stimulate the proliferation of blood vessel tissues and wrap them up. If the factors that damage the vascular endothelium cannot be removed, more and more "dead fat people" will live in, and the vascular endothelium will become thicker and thicker, so the blood vessels will become narrower, and human organs will be hypoxic and deficient. blood.

1. Stop loss in time: If the arterial endothelium is not damaged, cholesterol will not take advantage of it to form plaque. Therefore, the first step in reversing arterial plaque is to stop the damage in time and stop the factors that damage the arterial endothelium. The main factors that damage the arterial endothelium are hypertension, hyperlipidemia, diabetes, hyperuricemia and smoking.

The first four factors are all chronic diseases. Although they cannot be cured, they can be controlled with medication. For smoking, you need a strong self-control. As long as you can quit smoking, maintain regular medication, and control the indicators within the normal range, then arterial endothelial damage will not occur.

2. Lowering cholesterol: Human beings have been looking for ways to reverse arterial plaques. Since the cholesterol entering the vascular endothelium is the direct cause of plaques, then simply lowering the cholesterol in the blood can make the cholesterol in the vascular endothelium Cholesterol "countercurrent" out? Human beings have done related experiments, and the results have proved this point.

The main thing that enters the vascular endothelium is low-density lipoprotein cholesterol (LDL-C). When the LDL-C is reduced to 2.0mmol/L, the cholesterol will stop flowing into the vascular endothelium. When the LDL-C is reduced to 1.8mmol/L, the cholesterol in the vascular endothelium will flow back into the blood. That's why doctors recommend that people at high risk of cardiovascular and cerebrovascular diseases must control LDL-C below 1.8mmol/L.

3. Compress the "dead fat man": But lowering LDL-C will only make the cholesterol in the arterial endothelium flow back. The cholesterol that has been eaten by macrophages and turned into "dead fat people" cannot come out again. The existing scientific and technological means of human beings are unable to revive the "dead fat man", so we can only think of other methods.

Statins are needed to lower LDL-C. However, in the process of medication, humans have discovered that in addition to regulating blood lipids, statins can also improve the metabolism of arterial endothelium, reduce oxidation and inflammatory reactions, and can also compress the volume of "dead fat man" into a concentrated version of "fat man". Fatty". In this way, although the cholesterol in the core of the plaque was not removed, the core of the plaque was made smaller, and the reverse effect of shrinking the plaque was also realized.

1. Physiological phenomenon of body aging: After most people find carotid artery plaques, they will be very worried, for fear that the plaques will cause vascular diseases in the brain. But in reality, carotid plaque in most people is not dangerous. As mentioned earlier, the carotid artery bears a high pressure of blood washing, which itself is a particularly prone to plaque.

Plaque in the carotid arteries is a very common condition in people over the age of 40. Plaques in the carotid arteries occur in almost half of people over the age of 50. In people between the ages of 70 and 80, it is rare for the carotid artery to be free of plaque. That is to say, carotid plaque is not so much a disease as a physiological phenomenon of aging.

2. The risk of plaque: The risk of plaque lies in the unstable plaque, which is commonly referred to as "soft plaque". This kind of plaque has "thin skin and large filling". It breaks easily during spasms. It will activate the coagulation function of platelets, resulting in the formation of thrombus in blood vessels. The stable part of plaque, known as "hard plaque," is less likely to rupture.

"Soft plaque" is mainly seen in plaques caused by factors such as high blood pressure, high blood fat, high blood sugar, high blood uric acid, smoking, etc., while plaques formed by simple blood washing are usually "hard" in texture, and the growth rate is not fast, and they are It is not easy to break, and the degree of danger is not high.

1. Diagnosis basis of plaque: The diagnosis of carotid artery plaque is mainly judged by the thickness measurement of carotid artery intima with color Doppler ultrasound. Color Doppler ultrasound cannot identify the carotid intima and the dozens of layers of muscle tissue below it, but it can measure the thickness of the intima.

The normal intima thickness is 0.5-0.9 mm. When the thickness exceeds 1.0 mm, it is diagnosed as carotid intimal thickening. When the thickness exceeds 1.2 mm, it is diagnosed as carotid plaque. When the thickness exceeds 1.5 mm, it is generally diagnosed directly. For carotid artery stenosis.

2. Why the plaque disappears: The formation of carotid artery plaque originates from the damage of the arterial endothelium. As the human body ages, there will be more and more damage factors. Therefore, it is generally believed in medicine that once plaques appear in the arteries, it is difficult to completely disappear, but some methods can be used to reverse them.

For example, if you quit smoking, pay attention to a healthy diet, and increase the amount of exercise at the same time, or take drugs to lower blood lipids and concentrate the lipid core in the plaque, the volume of the plaque will shrink. Plaque shrinks in size, as does the thickness of the carotid intima. In this way, when the thickness of the carotid artery intima does not meet the diagnostic criteria for plaque during the re-examination of color Doppler ultrasound, the plaque will naturally "disappear".

The "disappearance" of plaque is likely to be only temporary, and as the body ages, plaque in the carotid artery will still reappear in the future. However, there is no need to worry about plaques. As long as the risk factors are well controlled and the plaques become "hard" and do not break down, you can let them grow old healthily and slowly with you. I am Hanako Pharmacist, welcome to follow me and share more health knowledge.

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