The carotid artery is the only way for blood to be transported from the heart to the brain. The internal carotid artery is responsible for the blood supply to the front and middle of the cerebral hemisphere. The bifurcation of the common carotid artery is prone to form atheroma due to slow blood flow and local turbulence. Hardened plaques.
The health of the carotid arteries can be used as a "window" to the arteries of the whole body. Studies have shown that the degree of carotid atherosclerosis is directly proportional to the degree of coronary heart disease and cerebral arteriosclerosis. Among middle-aged and elderly people over 45 years old, the detection rate of carotid artery plaque is close to 80% in patients diagnosed with stroke or transient ischemic attack.
It can be seen that if the patient has detected carotid atherosclerosis, it indicates that the cardiovascular and cerebrovascular atherosclerosis is likely to be more serious. This is because compared with the carotid arteries, the coronary arteries and cerebral blood vessels of the heart are thinner, have more bifurcations and bends, and are more likely to form atherosclerotic plaques.
Intervene early, the plaque can be reversed or even subside
If the carotid artery color Doppler ultrasound examination reveals that the patient's carotid artery intima is thickened or plaque is formed, but the degree of arterial stenosis has not exceeded 50%, active intervention at this time, the patient's plaque may be reversed or even subside.
On the basis of timely treatment and treatment, patients should improve their lifestyles and receive targeted therapeutic lifestyle interventions, including dietary interventions, maintaining a healthy lifestyle, and exercise.
(1) Diet intervention: The daily diet should be "three more and three less", that is, eat more fresh vegetables and fruits, eat more foods rich in plant sterols and dietary fiber, such as whole grains, whole grains, etc., eat more unsaturated Fatty acid foods, such as fish; eat less fatty meat, animal organs and other high-fat foods, control salt and sugar intake, strictly control total calories, and avoid overweight and obesity.
(2) Maintain a healthy lifestyle: quit smoking and limit alcohol, have a calm mind, learn to self-regulate and resolve bad emotions in time.
(3) Exercise intervention: choose the exercise that suits you, do what you can, and proceed step by step. Generally, moderate-intensity aerobic exercise is appropriate, 30 to 50 minutes each time, 3 to 5 times a week.
Cooperate with drugs and surgical treatment when necessary
If after lifestyle intervention, the low-density lipoprotein cholesterol level, blood sugar level, etc. still cannot reach the standard, or you have suffered from atherosclerotic disease, you must follow the doctor's advice and cooperate with medication, and you must not refuse to take the medication for fear of the side effects of the medication.
Patients need to take statins, antiplatelet drugs, and drugs to control high blood pressure and hyperglycemia. Generally speaking, the low-density lipoprotein cholesterol level of people with carotid plaque should be controlled below 2.6 mmol/L. If it is controlled below 1.8 mmol/L for a long time, it will be more conducive to the regression of hypoechoic soft plaques.
If the patient's carotid artery stenosis reaches more than 70%, in addition to taking drugs, he should also go to the vascular surgery clinic in time, and if necessary, undergo carotid endarterectomy or carotid stenting.
Hard plaque or soft plaque, which is more dangerous
Carotid artery color Doppler ultrasound is non-invasive, non-radiation, and repeatable. It is most suitable for the screening of vascular health and is also conducive to monitoring the progress of atherosclerosis and the treatment effect. In addition, the stability of carotid plaque can also be judged by the results of color Doppler ultrasound.
Many people have seen the words "hard plaque" and "soft plaque" on the inspection report, but do not understand the difference between them. Both hard and soft plaques are a description of the nature of plaques. The difference between them is:
hard plaques are mostly stable plaques, which have been calcified and hardened, and have a thicker fiber cap on the surface. It is easy to rupture secondary thrombus. This kind of plaque generally causes stenosis and blockage of blood vessels through continuous growth, thereby affecting the blood supply to the brain. However, the growth rate is not fast, and the risk of inducing acute cardiovascular and cerebrovascular events such as stroke is relatively small.
Soft plaques are mostly unstable plaques. Its fibrous cap is thin, like dumplings with thin skin and big stuffing. It is easy to rupture and secondary thrombus. Once the thrombus blocks the carotid artery or the plaque breaks off, it follows the blood flow. Entering the intracranial artery will affect the blood supply to the brain and induce stroke.
Therefore, hard plaques are relatively stable, the risk of rupture is relatively small, and the risk of inducing acute cardiovascular and cerebrovascular events is relatively small; while the risk of soft plaques is relatively greater and is likely to cause acute cardiovascular and cerebrovascular events. However, soft plaques can be reversed if they are intervened in time. Therefore, regular physical examinations, early screening, and early treatment are very important.
