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

Someone asked Hua Zi that he had carotid plaques detected a few years ago, but the plaques disappeared during the most recent examination. Doesn't it mean that arterial plaque cannot be reversed, so where did his plaque go? Hua Zi said, congratulations to his luck, the case of plaque reversal and disappearance is 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, there are also cases of carotid plaque disappearance, but it is very rare.

1. Damage to the carotid artery endothelium: The blood ejected from the human heart has a high pressure, and a "strong" pipeline is required for safe delivery. 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 branches. The arteries here are like "watersheds", subject to constant scouring of blood. Over time, the carotid artery endothelium will produce mechanical damage, and the cholesterol in the blood will take the opportunity to invade the arterial endothelium from the damaged place.

2. Macrophages have become "dead fat people": Cholesterol is a normal nutrient in the human body in the blood, but when it enters the endothelium of the arteries, it will produce reactions such as oxidation and inflammatory stimulation, and become "trouble molecules" ", the body sends out macrophages to deal with them. The way macrophages deal with cholesterol is very simple and crude, that is, "eat".

Macrophages eat cholesterol into their stomachs, and a small amount of cholesterol is "digested" by 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 died and became a "dead fat man", that is, transformed into foam cells. Many foam cells are deposited together and become the lipid core of atherosclerotic plaques, and carotid plaques are formed.

3. It is easy to ask God, but it is difficult: macrophages can move freely between tissues and 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 foam cells, it loses the ability to move, and can only settle down in place and be a "dead fat man" who dominates one side.

"Dead fat people" live in the vascular endothelium, which stimulates the proliferation of vascular tissue and encases them. 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 narrow, and the 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 the weakness to form plaques. 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, and although they cannot be cured, they can be controlled with medication. For smoking, you need strong self-control. As long as we can quit smoking, maintain regular medication, and control the indicators within the normal range, then arterial endothelial damage will not occur.

2. Lowering cholesterol: Humans have been looking for ways to reverse arterial plaques. Since the cholesterol entering the vascular endothelium is the direct cause of plaque, then simply lowering the cholesterol in the blood directly will make the vascular endothelial cells Cholesterol "countercurrent" out? Humans have done relevant experiments, and the results have proved this.

It is mainly low-density lipoprotein cholesterol (LDL-C) that enters the vascular endothelium. When LDL-C is reduced to 2.0 mmol/L, the flow of cholesterol into the vascular endothelium stops. When LDL-C is reduced to 1.8mmol/L, cholesterol in the vascular endothelium will flow back into the blood. Therefore, doctors recommend that people with extremely 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 allow the cholesterol in the arterial endothelium to flow back out. The cholesterol that has been eaten by macrophages and become "dead fat" can't come out again. Humans' existing scientific and technological means cannot revive the "dead fat man" again, so they can only think of other methods.

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

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

Plaque in the carotid arteries is a very common condition in people over the age of 40. In people over the age of 50, almost half of the people with plaque in the carotid arteries. In people 70 to 80 years old, it is rare that the carotid artery is free of plaque. In other words, plaque in the carotid artery is not so much a disease as it is a physiological phenomenon of aging.

2. The risk of plaque: The risk of plaque lies in unstable plaque, also known as "soft plaque", which is "thin and stuffy", which can be affected by severe fluctuations in blood pressure and blood vessels. It is easy to break when spasm. It activates the blood clotting function of platelets, resulting in the formation of blood clots. The stable plaques in the plaque, known as "hard plaques," are less likely to rupture.

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

1. Basis for diagnosis of plaque: The diagnosis of carotid plaque is mainly judged by the measurement of carotid intima thickness by color Doppler ultrasound. Color Doppler ultrasound cannot distinguish the carotid intima from 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 intima 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. Carotid artery stenosis.

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

For example, if you quit smoking in your life, pay attention to a healthy diet, and increase the amount of exercise at the same time, or take drugs, your blood lipids will be reduced, the lipid core in the plaque will be concentrated, and the volume of the plaque will be reduced. The size of the plaque shrinks and the thickness of the carotid intima also becomes thinner. In this way, when the thickness of the intima of the carotid artery does not meet the diagnostic criteria for plaque, the plaque will naturally "disappear" when the color Doppler ultrasound is performed.

The "disappearance" of plaque is likely to be 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 collapse, you can let them age healthily and slowly with you. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.

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