Cardiovascular events related to atherosclerotic plaques are one of the main causes of human death worldwide. In recent decades, many drugs have been developed to treat atherosclerotic plaques, and with the development of imaging, the effects of these drugs on plaques can be evaluated in more detail.
The formation of atherosclerotic plaque is caused by the long-term effects of smoking, hypertension, hyperlipidemia, diabetes and other pathogenic factors, which leads to the dysfunction of arterial endothelium and the increase of endothelial cell permeability, and makes low-density lipoprotein cholesterol (LDL-C) in blood enter the intima.
Macrophages in the intima will devour a large number of LDL-C, and eventually form foam cells deposited in 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 are controllable. As long as they are controlled in time, they can have a "radical effect" on atherosclerotic plaques.
Nicotine in cigarettes can 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 can 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 and pears; Coarse grains should account for 1/3 of the staple food, such as miscellaneous beans, oats and corn.
It contains soluble dietary fiber, which can inhibit cholesterol absorption; Eating deep-sea fish, such as tuna, salmon and sardines, 2 to 3 times a week, which contains omega-3 fatty acids, can reduce the level of bad cholesterol, but it needs to be cooked by steaming; Stay away from high-fat foods, especially animal fat and animal offal.
Because foam cells cannot be removed once they are formed, for a long time, people think that atherosclerotic plaques are irreversible. However, it was later found that some people's arterial diameter will increase, which means that the plaque has 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, and the lipid content will decrease, the density will increase, and the risk of rupture will become smaller.
However, 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 to be a stable plaque with little risk. Adjusting diet and exercise are effective intervention measures 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 the food eaten can only account for 30%.