How to eliminate atherosclerotic plaques?

Written by Zeng Wei Jie
Cardiology
Updated on September 01, 2024
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Arterial plaques associated with atherosclerosis are generally impossible to completely eliminate, but it is feasible to prevent the progression of the disease and strive for stable reversal. Achieving stability and reversal involves a balanced diet, appropriate physical and athletic activity, maintaining a positive mood, quitting smoking and limiting alcohol consumption, and actively controlling hypertension, diabetes, dyslipidemia, and obesity. Additionally, some medications that stabilize plaques may be necessary, mainly including lipid-modifying statins. For patients with soft plaques who are at risk of acute cardiovascular events, it may also be necessary to take anti-vascular medications. For those already showing signs of organ ischemia, interventional or surgical treatment may even be needed. (Please use medications under the guidance of a doctor.)

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Written by Zeng Wei Jie
Cardiology
52sec home-news-image

How is arteriosclerosis treated?

The treatment of arteriosclerosis includes general preventive measures, pharmacological treatment interventions, and surgical interventions. General protective measures include reasonable dietary practices, appropriate physical exercise, proper arrangement of work and life, maintaining a pleasant mood, quitting smoking, limiting alcohol consumption, and controlling some disease-related risk factors such as hypertension, diabetes, dyslipidemia, obesity, etc. The main pharmacological treatment focuses on lipid-lowering and antiplatelet medication. For some patients with symptoms of angina pectoris, such as symptoms of target organ damage, treatment may involve dilating the blood vessels. Interventional treatment indications are now relatively broad. For some who are not suitable for interventional procedures, surgical treatments can be considered.

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Written by Zeng Wei Jie
Cardiology
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Risk factors for arteriosclerosis

The etiology of atherosclerosis is not yet fully understood, but the main risk factors include age and gender. The older the age, the higher the probability of occurrence, and the probability in men is higher than in women. Abnormal blood lipids, with the main treatment target being low-density lipoprotein, hypertension, smoking, glucose tolerance abnormalities, and obesity are all possible risk factors. Additionally, we cannot ignore family history; if there is a history of early-onset coronary heart disease in the family, then this risk factor is also very high. Moreover, personality is related, with Type A personalities being more prone to atherosclerosis. Dietary habits are also related; patients who often eat high-calorie, high-animal-fat, high-cholesterol foods are prone to develop the condition. There are also patients taking oral contraceptives, who are likely to develop atherosclerosis.

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Written by Tang Li
Cardiology
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Causes of arteriosclerosis

The etiology of arteriosclerosis has not been fully determined, and studies indicate that arteriosclerosis is a multifactorial disease, caused by multiple factors acting at different stages, which are referred to as risk factors. The primary risk factors include the following: First, age and gender. Clinically, it is more common in middle-aged and elderly people over forty years old. After the age of forty-nine, the progression is fast, but early arteriosclerotic changes have also been found in autopsy of some young adults and even children. In recent years, clinical onset age tends to be younger. Compared to men, the incidence rate in women is lower, because estrogen has a protective effect against arteriosclerosis. Therefore, the incidence rate in women increases rapidly after menopause. Age and gender are unchangeable risk factors. Second, abnormal lipid levels, with abnormal lipid metabolism being the most important risk factor for arteriosclerosis. Third, hypertension, as the incidence of arteriosclerosis in patients with hypertension is significantly higher. Sixty to seventy percent of patients with coronary arteriosclerosis have hypertension, and patients with hypertension are three to four times more likely to have arteriosclerosis compared to those with normal blood pressure. Fourth, smoking, as the incidence and mortality rate of coronary arteriosclerosis in smokers are two to six times higher than in non-smokers, and it correlates positively with the number of cigarettes smoked daily. Secondhand smoke is also a risk factor. Fifth, diabetes and glucose intolerance, where not only is the incidence of arteriosclerosis in diabetic patients several times higher than in non-diabetics, but the progression of the disease is also rapid. Sixth, obesity, defined as being more than twenty percent over the standard weight or a BMI greater than twenty-four. Obesity is also a risk factor for arteriosclerosis. Seventh, family history, where a family history of coronary heart disease, diabetes, hypertension, and hyperlipidemia significantly increases the incidence of coronary heart disease. Various theories have been proposed to explain the pathogenesis of coronary arteriosclerosis from different perspectives. These include the lipid infiltration theory, thrombosis theory, and smooth muscle cell clonal theory. In recent years, the endothelial damage response theory has gained more support, suggesting that the disease results from various risk factors ultimately damaging the arterial intima, and the formation of arteriosclerosis lesions is an inflammatory, fibro-proliferative response of the arteries to endothelial damage.

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Written by Zhou Yan
Geriatrics
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Is coronary arteriosclerosis serious?

The severity of arterial atherosclerosis is related to the location of the lesion and the narrowing it causes in the coronary arteries. This is because if the blood flow through the coronary arteries is insufficient to meet the metabolic demands of the heart muscle, it can lead to ischemia and hypoxia of the heart muscle, causing angina. Severe and prolonged ischemia can lead to myocardial necrosis, or myocardial infarction. When there is significant narrowing in the coronary artery lumen, for instance more than 50%-75%, the situation can be compensated during rest. However, during exercise or rapid heart rate or emotional excitation, the oxygen demand of the heart muscle increases. This may result in mild or transient myocardial oxygen supply, or an imbalance between supply and demand. Another scenario involves unstable atherosclerotic plaques that rupture, erode, or bleed, leading to platelet aggregation or thrombus formation, causing a rapid worsening of luminal narrowing. This results in a decreased supply of oxygen to heart muscle, leading to acute coronary syndrome, which is very severe. In fact, the degree of coronary artery atherosclerosis is positively correlated with plaque stability, plaque location, and the elasticity of the coronary artery.

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Written by Chen Ya
Geriatrics
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How long can one live with arteriosclerosis?

Arteriosclerosis has a certain impact on survival and longevity, but it is not an absolute determinant. People with mild arteriosclerosis have fewer sudden incidents of cerebral infarction and myocardial infarction, thus they may have a longer survival period. However, if arteriosclerosis leads to myocardial infarction or cerebral infarction, it will also affect their lifespan, but there is no absolute conclusion.