Is it dangerous to have mixed plaques in the carotid artery? How can I reduce the risk?

An aunt told Huazi that she had multiple plaques in her carotid artery. In the ultrasound diagnosis report, most of the plaques were strong echoes, some were mixed echoes, and the stenosis was less than 50%. She asked Huazi, are strong echoes and mixed echoes dangerous? How can we reduce the risk?

Hua Zi said that in the ultrasound examination of carotid artery plaques, strong echoes and equal echoes indicate that the plaques are "hard" and more stable, while low echoes and mixed echoes indicate that the plaques are "soft" and less stable. But don't worry, as long as you take the medicine regularly, you can reduce the risk.

1. Causes of carotid plaques Carotid plaques are common in the middle-aged and elderly population. More than half of the people over 50 years old have carotid plaques. Carotid plaques are caused by factors such as high blood pressure, hyperlipidemia, diabetes, smoking, obesity, and aging, which cause damage to the carotid intima. Low-density lipoprotein cholesterol (LDL-C) in the blood enters the arterial intima from the damaged area.

Macrophages in the human body will engulf LDL-C that enters the intima and eventually transform into foam cells. Many foam cells are deposited together to form the lipid core of the plaque. With the current medical technology of mankind, there is no way to eliminate the plaque without destroying the intima of the artery. Therefore, once arterial plaque occurs, it cannot be completely cured.

2. Dangers of carotid artery plaques Many people are concerned about whether carotid artery plaques are dangerous and whether they can cause cerebral infarction. Hua Zi said that most carotid artery plaques are not dangerous. There are two types of dangers of carotid artery plaques. One is that the plaques continue to progress and grow, blocking the artery; the other is that the surface of the plaques ruptures, inducing platelet aggregation to form thrombi, blocking cerebral blood vessels.

For most people, plaques progress very slowly, and it takes decades to cause severe stenosis. As long as the "three highs" are controlled, the progression of plaques will be greatly delayed. Plaque rupture is the biggest risk we face. However, the presence of plaques in the carotid artery does not mean that cerebral infarction will definitely occur.

Only a very small part of cerebral infarction is caused by carotid artery plaques, and most of them are closely related to cerebral artery atherosclerosis. The carotid artery is close to the aorta and has a "Y"-shaped branch. It is subject to high blood flow pressure and is prone to mechanical damage. It is one of the blood vessels in the human body that is most likely to form plaques, but the probability of cerebral artery atherosclerosis is much lower than that of the carotid artery.

During ultrasound examination, if there is "strong echo" or "equal echo", it usually means that the plaque is homogeneous, with better stability and lower risk; if there is "low echo", it means that the plaque may contain more cholesterol or bleeding; if there is "mixed echo", different echo states are mixed together. The latter two types of plaques are less stable and slightly more dangerous.

3. Drug treatment of carotid artery plaques The presence of plaques in the carotid artery does not mean that there are plaques in the cerebral artery. It is also necessary to combine the analysis of the "soft" and "hard" nature of the plaques, the degree of "three highs", the length of illness, whether smoking, the degree of retinal arteriosclerosis and other factors for comprehensive judgment. Only those with high risk of illness need to take medication for treatment.

The key drug for treating carotid artery plaques is "statin". Statins can inhibit the synthesis of cholesterol. The formation of plaques is related to the level of low-density lipoprotein cholesterol (LDL-C) in blood lipids, so lowering the level of LDL-C can inhibit the progression of plaques.

Statins can also improve arterial intimal metabolism, inhibit oxidation and inflammatory reactions, reduce the size of the lipid core of the plaque, increase its density, and increase the stability of the plaque. Reducing LDL-C levels to below 1.8mmol/L and maintaining it for more than 2 to 4 years may reverse the plaque.

If the plaque is large, "soft" and easy to rupture, antiplatelet drugs such as aspirin are also needed. In this way, if the plaque ruptures, it can also inhibit platelet aggregation, avoid thrombosis and blockage of blood vessels. It should be noted that antiplatelet drugs need to be taken every day without interruption to effectively prevent thrombosis.

In summary, mixed plaques in the carotid artery are a "soft" plaque with slightly poor stability. They have certain risks and need to be analyzed in combination with factors such as "three highs", smoking, and obesity. If the risk of disease is high, medication treatment is required under the guidance of a doctor. If you have any doubts about medication, consult a doctor or pharmacist in time. I am pharmacist Huazi. Welcome to follow me and share more health knowledge.