Cardiovascular events related to atherosclerotic plaques are one of the main causes of human death all over the world. In recent decades, many drugs have been developed to treat atherosclerotic plaques. With the development of imaging, the effects of these drugs on plaques can be evaluated in more detail.
The formation of atherosclerotic plaque is due to the long-term effects of smoking, hypertension, hyperlipidemia, diabetes and other pathogenic factors, which leads to the dysfunction of arterial endothelium, the increase of endothelial cell permeability, and the low-density lipoprotein cholesterol (LDL-C) in blood entering the intima.
Macrophages in the intima will devour a large amount of LDL-C, and eventually form foam cells to deposit on the endothelium. Vascular smooth muscle cells proliferate around foam cells, forming fiber caps to cover their surfaces, which eventually leads to the formation of atherosclerotic plaques. Smoking, blood pressure, blood lipids, blood sugar and other pathogenic factors can be controlled. As long as it is controlled in time, it can have a "radical effect" on atherosclerotic plaques.
Nicotine in cigarettes will destroy the integrity of vascular endothelium, promote the deposition of lipid substances, and easily induce atherosclerosis, so cigarettes and second-hand smoke should be chosen. High calorie, high fat and high sugar diet will affect cardiovascular health, so we should actively improve the diet structure. Eat 500 grams of fresh vegetables and 250 grams of fruits every day, such as Chinese cabbage, celery, carrots, tomatoes, broccoli, apples, pears, etc. Coarse grains should account for 1/3 of the staple food, such as miscellaneous beans, oats and corn.
Contains soluble dietary fiber, which can inhibit cholesterol absorption; Eating deep-sea fish, such as tuna, salmon and sardines, twice or three times a week, which contains omega-3 fatty acids, can reduce the level of bad cholesterol, but it needs to be steamed; Stay away from high-fat foods, especially animal fat and animal offal.
Because foam cells cannot be removed once they are formed, it has long been considered that atherosclerotic plaques are irreversible. However, it was later found that some people's artery diameter would increase, indicating that the plaque had subsided. Modern imaging technology has confirmed that the size of the subsided plaque will not only become smaller, but also its internal composition will change, the lipid content will decrease, the density will increase, and the risk of rupture will decrease.
But not all plaques are reversible, such as hard plaques and calcified plaques, but the probability of rupture of this plaque itself is also very small, and it is considered as a stable plaque with little risk. Adjusting diet and exercise is an effective intervention measure for atherosclerotic plaque, but the effect of simply adjusting diet is limited, because 70% of LDL-C closely related to atherosclerotic plaque is produced by human body, and only 30% of food is eaten.