For all friends who encounter this kind of problem, "Does it need medication?" Some people say: If there are plaques on the arteries, you have to take statins to lower cholesterol, and at the same time, you have to take aspirin to prevent acute thrombosis.

Clinically, more and more friends have discovered the problem of "artery plaque" through various examinations. More common ones are found through ultrasound examinations: " carotid artery plaque " and "subclavicular artery plaque"; "coronary artery plaque" and "cerebral artery plaque" are found through CTA or angiography .

For all friends who encounter this kind of problem, "Do you need to take medicine to treat it?" is a very important question!

Some people say: If there are plaques on the arteries, you have to take statin to lower cholesterol . At the same time, you have to take aspirin to prevent acute thrombosis. In this article,

, let’s talk about whether there are “artery plaques” and you have to take statins and aspirin? And, how to judge whether you need to take medicine!

If there are arterial plaques ≠ you must take medicine!

From the current medical cognition, the harm caused by atherosclerotic plaques to health is mainly concentrated in two points:

First, arterial plaques can cause obvious stenosis of blood vessels. Once the arterial blood vessels are significantly narrowed, a very direct result is that the organ or tissue responsible for the blood supply will show ischemia.

For example, if the coronary artery that supplies blood to the heart is obviously narrowed, then it is prone to symptoms of heart ischemia such as angina pectoris; for example, a large part of the blood supply in the brain comes from the carotid artery. Once the carotid artery becomes significantly narrowed, it will show symptoms of insufficient blood supply to the brain; and if the lower limb artery becomes significantly narrowed, we will also experience the limb movement disorder such as " intermittent claudication ".

Second, arterial plaques may also rupture. In the rupture, the platelets in the blood will quickly gather together to form an acute thrombus. A thrombus can completely block the blood flow of arteries in an instant, which can directly cause acute necrosis of the organ or tissue!

is familiar to everyone. acute myocardial infarction is caused by sudden rupture of plaques on the coronary artery and forming acute thrombosis; in addition, thrombosis formed by rupture of carotid plaques can be washed into the brain by blood flow, blocking certain branches of the cerebral artery, and thus causing acute cerebral infarction .

Therefore, the most worrying thing about arterial plaque is that it will cause stenosis of blood vessels or may cause sudden rupture. However, not every arterial plaque has such a risk!

First of all, with the continuous advancement of medical imaging technology, we are increasingly able to detect arterial plaques in time in the early and mid-stage periods of their occurrence. Clinically, many patients have not caused obvious stenosis of the blood vessels when they discover arterial plaques.

Secondly, medical observations found that the characteristics of arterial plaques themselves show differently, and the risk of rupture is also completely different. Some "unstable" "vulnerable plaques" have a high risk of rupture; while some "relatively stable" plaques have a low risk of rupture!

That is to say, if the arterial plaque does not cause obvious stenosis of the blood vessels, and it is "relatively stable" and is not prone to rupture, then it is not necessary to use drugs to treat it!

And what kind of arterial plaques need to be treated with medication? We have to judge the answer to this question through three steps.

1 Look at the " Arterial Stenosis Degree"

After we check the problem of "artery plaque", the first thing we need to figure out is: Does the plaque cause blood vessel stenosis "more than 50%"?

"Vascular stenosis exceeds 50%", which is a very important dividing point in medicine!

For example, the "Guidelines for Diagnosis and Treatment of Stable Coronary Heart Disease" proposes: We can only diagnose " coronary heart disease " through coronary angiography (CAG).

And for patients diagnosed with coronary heart disease, there is no doubt that medication is needed! Not only do you need to take aspirin to prevent acute thrombosis, but you also need to take statins to control low-density lipoprotein cholesterol. In addition, beta-blockers are needed to slow down the heart rate and take "pril" or "sartan" drugs to protect the heart.

For example, the "Consensus on Diagnosis and Treatment of Atherosclerosis in the Head and Carotid Artery in China" points out: If plaque causes vascular stenosis exceeding 50%, then statins are required regardless of whether there are symptoms or whether blood lipids are normal! At the same time, doctors generally require such patients to take aspirin to prevent acute thrombosis.

In short, after discovering "artery plaque", the first thing to do is to see if it causes vascular stenosis by more than 50%. If so, you need to take statins and aspirin!

2. Look at "plaque stability"

. In the "Consensus on Diagnosis and Treatment of Atherosclerosis in the Chinese Head and Carotid Artery", it also emphasized that: patients with "unstable plaques" on the carotid artery are also recommended to take statins.

So, after discovering the problem of "artery plaque", the second thing you need to look at is how "stability" of the plaque is.

judges the stability of arterial plaques and requires doctors to make judgments based on some characteristics of arterial plaques on imaging examinations.

Generally speaking, if the density inside the plaque is low or the density is mixed; if the surface of the plaque is not smooth or irregular, then such plaques are mostly "unstable plaques".

Recommended that after you get the examination report for "artery plaque", you must remember to ask a doctor to help you evaluate whether your plaque is "unstable plaque". If so, then most of the statins are needed to help "stabilize" the plaque.

However, generally, if the plaque does not cause obvious stenosis of the blood vessels for the time being, then even if it is an "unstable plaque", it is not necessary to take aspirin.

3 Look at " cholesterol is high in not high"

If your artery plaques do not cause stenosis and are not "unstable" plaques, then whether you need to take medicine, in the end, just look at whether the cholesterol level in the blood lipid indicators is high.

If your LDL cholesterol level exceeds 3.4mmol/L, then it is recommended to take statins regardless of the size and nature of the plaque.

If the plaque does not cause obvious stenosis of the arteries, it does not belong to "unstable plaques", and the blood lipid indicators are still normal, then, in principle, statins and aspirin are not necessary!

"Consensus on Diagnosis and Treatment of Atherosclerosis in the Head and Carotid Artery" specifically points out: For such arterial plaques, the main treatment is to control cardiovascular risk factors such as hypertension , diabetes , smoking, and alcohol.

You can usually strengthen interventions in healthy lifestyles such as diet control and exercise.

Finally, to summarize, it does not mean that as long as arterial plaques are found, you must take statins and aspirin! Whether medicine is needed often depends on the three aspects of whether the blood vessels are narrowed, whether the plaques are stable, and whether the blood lipids are high.

[References]

1, Guidelines for the diagnosis and treatment of stable coronary heart disease "Chinese Journal of Cardiovascular Disease" September 2018 Volume 46 Issue 9

2, Consensus on diagnosis and treatment of head and neck atherosclerosis in China "Chinese Journal of Neurology" August 2017 Volume 50 Issue 8

3, Suggestions on Chinese Experts in Diagnosis and Treatment of Carotid Atherosclerosis Diseases in the Elderly "Chinese Journal of Gerontology" February 2013 Volume 32 Issue 2