Can arteriosclerosis be cured?

Written by Chen Ya
Geriatrics
Updated on September 11, 2024
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Atherosclerosis can only slow down its further progression and prevent the further occurrence of conditions such as coronary heart disease, cerebral infarction, and lower limb arterial occlusion. This is because it is influenced by many factors, including both modifiable and non-modifiable risk factors. For example, modifiable factors include abnormal blood lipids, hypertension, diabetes, smoking, and overweight obesity, which we can change. However, there are also non-modifiable factors such as age, genetics, and environmental factors. As age increases, the incidence of atherosclerosis significantly rises. Its pathological changes generally begin in childhood or adolescence, with symptoms becoming more apparent as age progresses.

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Written by Zeng Wei Jie
Cardiology
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How to eliminate atherosclerotic plaques?

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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How is arteriosclerosis treated?

The treatment of arteriosclerosis includes general preventive measures, pharmacological treatment interventions, and surgical interventions. General protective measures include reasonable dietary practices, appropriate physical exercise, proper arrangement of work and life, maintaining a pleasant mood, quitting smoking, limiting alcohol consumption, and controlling some disease-related risk factors such as hypertension, diabetes, dyslipidemia, obesity, etc. The main pharmacological treatment focuses on lipid-lowering and antiplatelet medication. For some patients with symptoms of angina pectoris, such as symptoms of target organ damage, treatment may involve dilating the blood vessels. Interventional treatment indications are now relatively broad. For some who are not suitable for interventional procedures, surgical treatments can be considered.

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Written by Zeng Wei Jie
Cardiology
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The earliest lesions of arteriosclerosis

The earliest lesion of atherosclerosis is the formation of lipid spots and streaks. The so-called lipid spots are small yellow dots that appear on the arterial intima. Under pathological observation, these are small areas of macrophages containing lipid droplets, forming a cluster of foam cells. As this small yellow dot develops, it gradually turns into a yellow streak made up of layers of macrophages containing lipids. The intima also comprises smooth muscle cells and lipids, as well as an infiltration of T cells, resembling a yellow streak on the intima.

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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 Zhou Yan
Geriatrics
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Is coronary arteriosclerosis serious?

The severity of arterial atherosclerosis is related to the location of the lesion and the narrowing it causes in the coronary arteries. This is because if the blood flow through the coronary arteries is insufficient to meet the metabolic demands of the heart muscle, it can lead to ischemia and hypoxia of the heart muscle, causing angina. Severe and prolonged ischemia can lead to myocardial necrosis, or myocardial infarction. When there is significant narrowing in the coronary artery lumen, for instance more than 50%-75%, the situation can be compensated during rest. However, during exercise or rapid heart rate or emotional excitation, the oxygen demand of the heart muscle increases. This may result in mild or transient myocardial oxygen supply, or an imbalance between supply and demand. Another scenario involves unstable atherosclerotic plaques that rupture, erode, or bleed, leading to platelet aggregation or thrombus formation, causing a rapid worsening of luminal narrowing. This results in a decreased supply of oxygen to heart muscle, leading to acute coronary syndrome, which is very severe. In fact, the degree of coronary artery atherosclerosis is positively correlated with plaque stability, plaque location, and the elasticity of the coronary artery.