The formation of carotid plaque is related to intimal injury. When the intima is damaged, low density lipoprotein cholesterol (LDL-C) in the blood will enter the intima from the damaged site and be deposited.
These LDL-C entering the intima of blood vessels will be recognized as "foreign bodies", and the human body will mobilize macrophages to enter the intima of blood vessels for phagocytosis. Macrophages that devour too much LDL-C will become foam cells and gather together to form a yellowish "rice porridge"-like foam cell group. Due to the self-protection function, vascular smooth muscle cells will proliferate and cover foam cells, thus forming atherosclerotic plaques.
There is a Y-shaped branch in the human carotid artery, where the blood pressure is high and the intima of the blood vessel is easily damaged. The factors that can cause intimal injury are blood pressure, smoking, trauma, hyperglycemia, hyperlipidemia and age. Except age, other risk factors are artificially controllable.
Second, what can aspirin do?
In recent years, aspirin has become a health care "magic medicine" that is passed down from mouth to mouth and must be taken by middle-aged and elderly people. Judging from the history of human medicine, aspirin has made great contributions to mankind, and it seems too much to call it a "magic medicine". But whether it is "god" or "non-god", aspirin is first and foremost a "medicine". If it is a drug, there are indications, adverse reactions and contraindications. So not everyone can take aspirin.
Early aspirin was used to reduce fever and relieve pain, and now people still use high-dose aspirin to fight rheumatism. In the course of use, it was found that aspirin can also inhibit platelet aggregation and weaken human coagulation function. This function is a bit "chicken ribs" for healthy people, but anticoagulation is a great benefit for patients with high risk of thrombotic cardiovascular and cerebrovascular diseases. When platelet function is weakened, blood will not coagulate in blood vessels, and diseases such as myocardial infarction and cerebral infarction that may have occurred will not occur. Long-term experiments show that aspirin can reduce the probability of thrombotic diseases in high-risk patients by 24%.
However, taking aspirin has side effects, that is, it will affect the integrity of gastric mucosa and weaken the coagulation function of human body, which will lead to gastric ulcer and gastric bleeding. Therefore, people who take aspirin every day to prevent thrombosis need to take enteric-coated tablets to avoid direct irritation to the stomach, pay close attention to whether they have gastrointestinal discomfort and bleeding tendency, and consult doctors regularly to determine whether aspirin can be taken for a long time.
Third, aspirin and carotid plaque
Judging from the risk factors of carotid plaque, aspirin can't lower blood pressure, blood lipid and blood sugar, and can't rejuvenate people, so aspirin actually has no effect on preventing carotid plaque! For people who already have plaques, aspirin is just a preventive measure of "better late than never".
Platelets in the human body flow in blood vessels, and when the human body is injured, they will gather at the wound, activate blood coagulation function and prevent precious blood from flowing out. However, platelets have a characteristic, that is, when they encounter rough and uneven surfaces, it is easy to stimulate coagulation function. This is why we usually dress the wound and cover it with gauze with rough surface instead of smooth adhesive tape.
Normal blood vessels are unobstructed and will not stimulate the coagulation function of platelets. However, the surface of intravascular plaque is uneven, and platelets are easy to gather here. Plaque itself will also narrow the inner diameter of blood vessels, and platelets will gather here, which will easily lead to blood vessel blockage and disease.
Aspirin can inhibit platelet aggregation and keep blood vessels open. The human body constantly produces new platelets every day, so it needs to take aspirin on time every day to continue to play the role of inhibiting platelets and protect cardiovascular and cerebrovascular diseases. After stopping taking aspirin for more than 48 hours, the protective effect disappeared. Therefore, people who take aspirin are advised not to stop taking it easily unless there are unbearable adverse reactions.
Carotid plaque is the manifestation of atherosclerosis. Coronary atherosclerosis may cause coronary heart disease, while carotid atherosclerosis may cause carotid plaque. Arterial plaque is caused by the deposition of macromolecules such as fat in vascular endothelium after injury, which causes a series of inflammatory reactions and leads to vascular atherosclerosis. When atherosclerosis is serious in some places, plaques will form. Because the blood flow at the bifurcation of the common carotid artery is slow and there is vortex, carotid plaque is prone to occur here. Male over 60 years old, long-term smoking history, hypertension history, diabetes history and hyperlipidemia are the risk factors for carotid plaque formation. Once carotid plaque appears, the plaque will gradually increase, leading to carotid stenosis and insufficient blood supply to the brain.
Carotid plaque is covered with a layer of fibrous tissue called fibrous cap. The thickness of fibrous cap plays an important role in protecting the lipid components in plaque. The thicker the fiber cap, the less likely it is to expose the substances inside. For unstable plaque, it is easy to rupture. After plaque rupture, the lipid components in it are exposed to the blood, which will lead to platelet aggregation, and then form thrombus to block the carotid artery, and the thrombus in the plaque will fall off to form embolus, leading to intracranial arterial embolism.
The mechanism of aspirin is to inhibit the synthesis of thromboxane A2 and platelet aggregation by inhibiting cyclooxygenase, thus preventing thrombosis. Oral aspirin has irreplaceable therapeutic and preventive effects on ischemic cardiovascular and cerebrovascular diseases, such as coronary heart disease, cerebral infarction, acute unstable angina pectoris and myocardial infarction.
Therefore, as can be seen from the above, the function of aspirin is to inhibit the aggregation of platelets in the blood at the rupture site after the plaque ruptures, that is, to minimize the formation of local thrombus in the plaque. So taking aspirin every day can't prevent the formation of carotid plaque.
So, how to prevent carotid plaque? That is to minimize the high-risk factors of plaque formation, mainly including two aspects. One is to remove the factors that damage vascular endothelium. Hypertension, hyperglycemia, high uric acid, lack of exercise, staying up late for a long time, smoking, drinking, etc. It will damage vascular endothelium and create conditions for fat deposition; At the same time, these factors will also stimulate the plaque that has already formed, leading to plaque rupture. Therefore, quitting smoking and drinking, controlling blood pressure and blood sugar, reducing uric acid, exercising regularly and developing good eating habits and living habits can prevent carotid plaque. The second is to remove the factors that promote fat deposition as much as possible. Due to the increase of low density lipoprotein, more fat will be transported to vascular endothelium. Therefore, when plaque appears, low density lipoprotein should be strictly controlled. The low-density lipoprotein of people without cardiovascular disease should be controlled below 2.6mmol/L, and the low-density lipoprotein of people with cardiovascular and cerebrovascular diseases should be controlled below 65,438 0.6 mmol/L. The control methods include exercise, weight loss, diet control and oral statins.
Carotid plaque is caused by hyperlipidemia or blood viscosity. Because of hyperlipidemia or blood viscosity and poor blood fluidity, lipid substances in blood slowly adsorb on the blood vessel wall, thus forming millet-like atherosclerosis on the blood vessel wall.
As atherosclerosis becomes thicker and thicker, it is inevitable that some plaques will fall off. The detached plaque is very small and can be excreted with sweat and urine. Larger plaques remain in the blood and are separated from the blood. Due to the decrease of anticoagulant factors in blood, platelets increase, and the volume gradually increases to form thrombus.
Blood is thick, which is called blood stasis or blood poison in traditional Chinese medicine and high viscosity in western medicine. Blood viscosity is that the surface of red blood cells is covered with a layer of lipid substance, which makes red blood cells lose their normal negative charges and cannot repel each other and stick together, thus making red blood cells lose their normal ability to carry oxygen and waste gas and their deformability, causing obstacles to the blood microcirculation system, seriously affecting the oxygen supply and blood supply of organs and cells, thus producing a series of diseases.
The source of all diseases comes from blood!
The formation of carotid plaque originates from hyperlipidemia or blood viscosity. In order to prevent the formation of plaque, we must first improve blood, change blood viscosity or reduce blood lipid. How to reduce blood fat or improve blood viscosity?
Drug treatment is immediate and effective. But you need to take it often, maybe every day, for life. All drugs have more or less toxic side effects, that is to say, drugs are toxic in three ways. For some people, taking aspirin for a long time will hurt the stomach. Before the disease is cured, they hurt their stomachs first. Taking statins for a long time is very likely to damage the liver for some people. Blood lipid didn't drop, but it hurt the liver. These are all in a dilemma. Take medicine for a long time. It may hurt the liver and stomach, so don't take medicine to control it, which will increase blood lipid and thicken blood.
If the side effects of drugs are great, they should be treated with food. The biggest feature of food physiotherapy is that the ingredients are widely available, economical and have no side effects. But the effect is slow, and it takes a long time to eat, which requires long-term or lifelong consumption.
In addition, in addition to the above two methods, there is a third method, which is weak laser physiotherapy. This method is not recognized by most people, and it is also regarded as a scourge by most people, and it is considered to be cheating money. Low-level laser physiotherapy itself can't cure diseases, it just uses a wavelength of 650 nanometers and a power of 20 milliwatts (remember! It is 20mW, which is several times lower than that of 1W bulb. Who has seen 1W light bulb hurt people's skin? ) Weak red laser irradiates the skin, muscle and blood vessel wall of the left radial artery. About two milliwatts of laser enters the blood, reacts with the blood, activates active enzymes in the blood, decomposes and dissolves lipid substances wrapped in red blood cells, increases the ability of red blood cells to carry oxygen and deform waste gas, promotes the fluidity of blood, and slowly metabolizes lipid substances in the blood and atherosclerosis on the blood vessel wall, and excretes them through sweat and urine. So as to clean blood, bathe red blood cells, soften blood vessels, prevent plaque from falling off, improve blood viscosity, improve blood quality and reduce the risk of cardiovascular and cerebrovascular diseases!
Low intensity laser physiotherapy can improve blood viscosity. It can be used to irradiate the left radial artery twice a day in the morning and evening for 30 minutes each time, and it only takes about ten days to improve blood viscosity. As long as you persist in radiotherapy for four to six months, hyperlipidemia will be obviously improved and alleviated. As long as the drug is used for half a year to one year, both hypertension and diabetes have improved significantly. If the weak laser absorbs well, it can achieve the purpose of reducing medicine or stopping medicine!
To prevent carotid blood vessels from falling off, we must start with improving blood quality!
Middle-aged people can't help it, holding aspirin in their arms and holding a thermos cup for soaking medlar in their hands.
In fact, aspirin is not for everyone, nor for middle-aged people. Don't make fun of it It's medicine
Aspirin is an antiplatelet drug. It irreversibly blocks the action of cyclooxygenase-1(COX 1), which reduces thromboxane A2 produced by platelets. Aspirin inhibits platelet aggregation and forms blood clots. Reducing the ability of blood coagulation can reduce the risk of stroke or heart attack caused by brain or heart thrombosis.
What is plaque? Plaque is cholesterol, not the accumulation of fat. So I can definitely tell you that it can't prevent carotid plaque.
So why do some doctors let you take aspirin when you have plaque?
There is a difference here. Patients with plaque, especially ulcer plaque and vulnerable plaque, need to take aspirin. Because aspirin has anti-inflammatory and antiplatelet effects. Once the ulcer plaque breaks the coagulation mechanism of human body, it will quickly gather at the damaged part to help it solidify, and then block or block the damaged part. Obstruct blood flow, lead to blood supply ischemia, and form cerebral infarction or myocardial infarction.
The second situation is the patients who have already had cerebral infarction, which is the people who must take aspirin. In view of the previous illness, it is necessary to take aspirin to prevent the second attack.
Then there is another category, that is, patients who have no symptoms and are not at high risk of plaque. They don't really need to take aspirin. I told you before that aspirin is only an antiplatelet drug, which can't clear or control the development of plaque.
For middle-aged people, the irregular life of smoking and drinking in the first half of their lives can be improved by improving their living habits and taking statins. Aspirin is to prevent blood clots from blocking blood vessels caused by plaque rupture.
Do you know that?/You know what? It can't prevent carotid plaque.
Aspirin can not prevent the formation of carotid plaque, nor is it an essential drug for carotid plaque.
First of all, carotid plaque is a natural physiological phenomenon of human body, so don't be too alarmed. It is found that 36.2% of residents aged 40 and above in China have carotid atherosclerosis, and carotid plaque is also a manifestation of human vascular aging. About 20-30% patients with carotid plaque will have a stroke, so carotid plaque also needs attention. The formation of carotid plaque is mainly related to blood lipid, smoking, alcoholism, less physical activity, obesity, hypertension, diabetes and so on. For the prevention of carotid plaque, it is mainly to control these risk factors, which has nothing to do with taking aspirin or not. Oral aspirin can not prevent the formation of carotid plaque.
As for the treatment of carotid plaque, it is mainly based on the comprehensive evaluation of the degree of plaque stenosis, blood lipid level, the nature of plaque, whether it is complicated with stroke, coronary heart disease and other risk factors, and the most important thing is the lipid-lowering treatment of statins. Aspirin is not a necessary drug to treat carotid plaque. Whether it should be used mainly depends on whether there are other clinical complications and overall cardiovascular risk factors, such as whether it is complicated with cerebral infarction and coronary heart disease, whether it belongs to the high-risk group of cardiovascular and cerebrovascular diseases (ASCVD & gt 10%), and it is not necessary for other patients with carotid plaque to take aspirin.
Can't! Aspirin can't be used as a life-saving medicine for everyone!
This is a special concern for middle-aged and elderly people. It shows that people are paying more and more attention to health knowledge, but they are amateurs after all, so many people are willing to read popular science articles. So, I will think it over before writing. If these articles are well written, they will convey incorrect information, which will be like brainwashing in pyramid schemes.
First of all, don't take aspirin as a health product. Anyone can eat when they are old. If we objectively evaluate the merits and demerits of aspirin, we can only say that those who have to take aspirin are right: 9/ 10, and those who don't have to take aspirin may only take it without merits and demerits. Because aspirin, whether it is a real enteric-coated tablet, a vegetarian tablet or a sugar-coated tablet, can inhibit COX 1 from damaging the gastric mucosa in the blood, and can be directly dissolved in the stomach. Salicylic acid directly damages the gastric mucosa, which is the most common side effect of gastrointestinal bleeding, and occasionally a large amount of gastric mucosal bleeding is difficult to rescue. Once any part of the body bleeds during medication, the situation will be worse: it will aggravate the bleeding and it is not easy to stop bleeding. Not to mention it can induce asthma, allergies and kidney damage. So people who want to eat must eat.
Because the real function of aspirin is to prevent platelets activated by thromboxane A2 pathway from exposing IIbIIIa receptors, that is, fibrin variants, at the moment of plaque rupture. Without fibrin connection, the broken plaque is not activated or even activated platelets cannot aggregate into thrombus. Many articles think that blood viscosity is high, lipid flows out after plaque rupture, and platelets meet the "rough" surface of plaque, which are impossible to talk about. The sudden onset of blood flow is mainly white thrombus, while the slow blood flow or thrombus meets the activated fibrinolytic system in vivo to resist the slow formation of thrombus. The thrombus in pre-ischemia and collateral circulation is mainly connected with fibrin, and the red thrombus formed by platelets and stranded red blood cells.
Therefore, people who really need to take aspirin include:
1. There have been myocardial infarction and cerebral infarction, that is, plaque rupture and cerebral artery thrombosis (excluding cerebral infarction, it is unreasonable to say that cerebral infarction is a precursor of cerebral thrombosis. There are many hypotheses such as cerebral artery aging, small embolus shedding, cerebral artery spasm, etc., but cerebral infarction is definitely positively related to age. Most people in their seventies and eighties have cerebral infarction, and it is multiple. Occurred in the functional area with mild transient symptoms, occurred in the non-functional area without knowledge) or after stent implantation.
2. Fatigue angina or unstable angina in acute coronary syndrome diagnosed by more than two qualified cardiovascular physicians: initial angina, worsening and progressive angina, supine angina, variant angina (vasospasm) and recurrent angina after myocardial infarction.
3. Vascular ultrasound (at least two different hospitals) found that the artery was obviously narrowed with multiple soft plaques, the three highs (no matter how many) were not well controlled, the emotional impulse was out of control, and smoking was more than 1-2 packs a day.
From the anatomical point of view, the main cause of carotid plaque formation is that it is the largest and closest aorta branching from the aorta, so it bears great pressure of blood flow impulse. The main causes of intimal injury are directly related to age and uncontrolled hypertension. Therefore, it is very common for people over the age of 50 and 60 to find carotid plaque by vascular B-ultrasound. However, the speed of plaque growth is closely related to the levels of high and low density lipoprotein cholesterol LDL, the blood sugar control of diabetes mellitus, whether the blood pressure drops below 140/90mmHg, the amount of smoking and the length of time.
Only by understanding how carotid plaque is formed can we know whether aspirin can prevent the formation of plaque. Stimulated by blood pressure, blood lipid infiltration and glucose toxicity, the intima of the artery is damaged, and LDL, a low-density lipoprotein cholesterol, invades the intima of the damaged blood vessel, and at the same time, an inflammatory reaction occurs to produce chemokines, so that a large number of macrophages, monocytes and leukocytes that oxidize LDL engulf and form uncontrolled expansion foam cells, and countless foam cells pile up together to form the core lipid of plaque, and the outer layer is wrapped by the fibrous cap of connective tissue. The core lipid body grows too fast and the fiber cap is very thin. This kind of plaque is easy to rupture, especially in arterial spasm, which is called unstable brittle soft plaque. On the contrary, due to the aging of vascular intima, although LDL invades, the number is small and the inflammatory reaction is slight. The core lipid of this plaque is less, and the fiber cap is thicker when it grows slowly, which is called stable and not easy to be damaged. Don't worry about this plaque.
Therefore, middle-aged and elderly people should control their blood pressure, blood lipids and blood sugar, quit eating and drinking, and gain weight every day. Don't worry about carotid plaque. Ultrasound generally describes the length and width of plaque, usually a few millimeters or a dozen millimeters, and sometimes it also writes the thickness. If you write about carotid artery stenosis, it means that the plaque grows faster, which means that you have not controlled the "three highs" well, or the inheritance is not good. If the stenosis exceeds 30-50%, if the stenosis exceeds 70%, consider adding antiplatelet aspirin. If there is only plaque or mild stenosis, it is recommended that you do carotid B-ultrasound once a year to compare the progress of plaque and stenosis before deciding on medication. Is that clear?
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The first answer is no! The reason for this is the following：
Aspirin can inhibit platelet aggregation and prevent transient ischemic attack, myocardial infarction, atrial fibrillation, artificial heart valve, arteriovenous fistula or other postoperative thrombosis.
Aspirin, as an antiplatelet drug, is mainly used for the prevention and treatment of arterial thromboembolism, but its effect on venous diseases is relatively small, which is obviously lower than that of anticoagulant drugs (such as warfarin) or Chinese patent medicine antithrombotic drugs (Luomaishutong Pill).
In addition, aspirin is not recommended when the risk of thromboembolism is low. That is to say, if the risk of acute thromboembolism is not great, then the use of aspirin to prevent thrombosis is a kind of "not worth the loss", and the side effects such as bleeding outweigh its positive effects.
To sum up, aspirin is not recommended in life to prevent thrombosis and plaque.
1. Aspirin is an anti-platelet aggregation drug, which can not only prevent carotid plaque, but also prevent cardiovascular and cerebrovascular events. Platelets play an important role in the process of arterial thrombosis. When arterial thrombotic plaque ruptures, platelet adhesion occurs, and a large number of procoagulant active substances are released during the adhesion process, and then platelet aggregation occurs, forming platelet thrombus and adhering to the ruptured blood vessel wall. With the rupture and shedding of plaque, thrombosis occurs in cardiac blood vessels leading to myocardial infarction, cerebral blood vessels leading to cerebral infarction, and peripheral blood vessels leading to pulmonary embolism and venous embolism of lower limbs.
Therefore, antiplatelet drugs are needed to prevent plaque formation.
Second, who needs oral drugs?
The general clinical evaluation method is that if the risk of cardiovascular and cerebrovascular events in patients within 10 years is greater than 10%, drug intervention must be taken. In other words, if there are risk factors: hypertension, diabetes, hyperlipidemia, obesity, smoking, family history. And men over 40 (women over 50) have two or more risk factors, or men over 50 (women over 60) have one or more risk factors.
Three, do not recommend drug intervention are:
Low-risk people, the prevention of the first stroke is that there are no risk factors and no people who have had a stroke before; Diabetes with diabetes or without peripheral vascular disease means that diabetic patients have never had a stroke before and have no cerebrovascular or cardiovascular diseases; High-risk groups with bleeding tendency.
4. How many doses of preventive drugs do you take every day?
The recommended optimal dosage is 75~ 150mg per day. Studies have shown that a small dose can prevent cardiovascular and cerebrovascular events, and will not increase the antiplatelet effect and reduce the occurrence of adverse events because of the increase of dose. On the contrary, long-term high-dose oral administration will stimulate the gastric mucosa and cause the risk of bleeding. Low dose oral administration is effective and the risk of bleeding is small.
5. When is the best time to take medicine?
The blood concentration is the highest 3~4 hours after taking the medicine. Generally, the high incidence of cardiovascular and cerebrovascular events is 6~ 12, so many people think it is better to take medicine at night. According to the rapid emptying of drugs in the stomach and absorption in the intestine, it is more beneficial to take drugs in the morning. It is best to take it on an empty stomach according to your own situation (whether you have stomach trouble) and the dosage form of the drug (intestinal solvent is recommended, which is beneficial to the absorption and bioavailability of the drug; Non-enteric solvents are recommended to be taken after meals, which is conducive to reducing adverse reactions and improving tolerance) and choosing the best time to take drugs.
All drugs are a double-edged sword, and there are no drugs with adverse reactions. It is the most basic principle to consider that the benefits of drugs far outweigh the risks in the treatment process. If the benefits of this medicine far outweigh the risks, it means that it is a good medicine.
I am a doctor with small eyes.
Pay attention to cardiovascular and cerebrovascular diseases
Committed to public health
A cardiologist who loves fitness.
If there is carotid plaque formation, aspirin enteric-coated tablets should be taken regularly.
It is all because of the formation of atherosclerosis of blood vessels, and finally the formation of arterial plaques. Therefore, taking aspirin enteric-coated tablets is effective.
Moreover, in the prevention of atherosclerotic diseases, aspirin is absolutely the basic treatment.
Because aspirin enteric-coated tablets not only have the effect of inhibiting platelets, but also have the effect of anti-inflammation.
Because inflammation is also a major mechanism of atherosclerosis. In addition, if your risk of bleeding is high, please make a comprehensive evaluation before deciding whether to take the medicine.
I am a doctor with small eyes.
If you think my answer is not good, you can reply and tell me.
Aspirin can indeed prevent cardiovascular and cerebrovascular infarction, but we should not forget that aspirin also has side effects. For example, aspirin can inhibit the function of platelets, and platelets are an important participant in our hemostatic system. When the function of platelets is inhibited, it is not easy to form hemostatic lumps in our blood vessels. This is why aspirin can not only prevent cardiovascular and cerebrovascular infarction, but also increase the risk of bleeding, such as cerebral hemorrhage, gastric bleeding, intestinal bleeding, hematuria, nosebleeds, gingival bleeding and so on. In addition, it will also cause damage to the gastric mucosa.
Therefore, if a normal person does not have the risk of cerebral infarction or myocardial infarction, taking aspirin for a long time will not reduce the possibility of cerebral infarction and myocardial infarction, but will increase the risk of cerebral hemorrhage, gastric bleeding and other organ bleeding.
In other words, it is not worth the loss.
Not to mention taking aspirin to prevent cervical vascular plaque.
Take aspirin for a long time. Only after the doctor evaluates it, do you think it is necessary to take aspirin. Never listen to others saying that eating this can prevent cerebral infarction. Start eating it yourself. Otherwise, the consequences are unimaginable, not only can not prolong life, but also may enter the intensive care unit of the hospital early.