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
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Arteriosclerosis is divided into several stages.

Arterial atherosclerosis sequentially manifests as three major types: lipid spots and stripes, atheromatous and fibrous atheromatous plaques, and complex lesions. According to the process of its occurrence and development, it can be subdivided into six types. The first type is lipid spots, which are small yellow spots on the arterial intima that gradually develop into the second type, lipid stripes, where some yellow stripes appear on the arterial intima. Then there is the third type, pre-lesional plaque, where more lipid droplets appear extracellularly. The fourth type is the atheromatous plaque, where lipids accumulate excessively and form lipid pools, and the intimal structure will be damaged. The fifth type is the fibrous atheromatous plaque, which is the most characteristic lesion of arterial atherosclerosis. The sixth type is a complex lesion, representing a severe condition.

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Written by Zeng Wei Jie
Cardiology
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How is arteriosclerosis treated?

To treat arteriosclerosis, we differentiate treatments based on the severity of the condition. For early-stage patients, we emphasize the control of lipids, blood pressure, and blood sugar to potentially slow the progression of arteriosclerosis. For patients who have already suffered damage to target organs, such as cerebral infarction, myocardial infarction, renal artery stenosis, or mesenteric artery stenosis, treatment might significantly rely on medication, and could possibly require the use of stents or even surgical bypass procedures. For the general population, we emphasize primary prevention, which includes a reasonable diet, appropriate exercise, and a balanced mental state to effectively prevent the disease.

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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 Zeng Wei Jie
Cardiology
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What medicine is used for arteriosclerosis?

Commonly, some medications used to adjust blood lipids are employed, primarily to lower low-density lipoprotein levels, and some are also aimed at achieving target levels for triglycerides. These include statins, fibrates, and niacin. For some patients, antiplatelet drugs might be necessary to prevent acute thrombus formation and avoid acute incidents. For those who have already formed a thrombus, thrombolytic drugs can be used within a certain time window for some patients. For patients with coronary artery accumulation leading to angina, vasodilators, receptor blockers, or calcium channel antagonists might be used to alleviate the symptoms of angina.

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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.