Definition and epidemiology
• Atherosclerosis is a disease of the arteries characterized by lipid deposits, fibroplasia, and calcareous deposits within the arterial wall, leading to narrowing and hardening of the arteries.
• Epidemiology: Atherosclerosis is a common disease worldwide and its incidence increases with age. Hypertension, hyperlipidemia, diabetes and smoking are the main risk factors for atherosclerosis.
The mechanism
of atherosclerosis
• Endothelial injury: Endothelial injury of arteries is the initial step of atherosclerosis, and the injury can lead to endothelial dysfunction and promote lipid deposition and inflammatory response.
• Fibroplasia: smooth muscle cells migrate from the media to the intima of the artery: and proliferate to form a fibrous cap that overlies the lipid plaque.
• Lipid deposition: Lipids are deposited under the inner membrane to form lipid streaks, which gradually evolve into lipid plaques composed of cholesterol esters, phospholipids, and triglycerides.
• Calcareous deposits: Calcareous deposits can occur inside plaques, increasing plaque stiffness.
Risk factors
for atherosclerosis
• Hypertension: Long-term hypertension causes damage to the arteries’ endothelium, accelerating lipid deposition and plaque formation.
• Diabetes: People with diabetes often have metabolic disorders and vascular disease, which increases the risk of atherosclerosis.
• Age: With age, the structure and function of the arterial wall gradually deteriorate, increasing the risk of atherosclerosis.
• Hyperlipidemia: Hyperlipidemia is one of the most important risk factors for atherosclerosis, and high cholesterol and triglyceride levels promote lipid deposition.
• Smoking: Harmful substances in tobacco can directly damage arterial endothelium and promote the development of atherosclerosis.
Clinical signs
of atherosclerosis.
• Symptoms: Symptoms of atherosclerosis vary depending on the location and extent of the affected blood vessel and may include angina, cerebral ischemia, intermittent claudication of the lower extremities, etc.
• Signs: Your doctor may notice signs such as elevated blood pressure and abnormal pulse, which may be related to atherosclerosis.
Imaging Diagnosis
of Atherosclerosis
• Ultrasound: Ultrasound allows the doctor to observe the blood flow in the blood vessels and assess the degree of stenosis.
• CT angiography (CTA): CTA can clearly show the three-dimensional structure of blood vessels and help doctors judge the nature of plaques and the degree of stenosis.
• Magnetic Resonance Angiography (MRA): MRA is a noninvasive vascular imaging technique that can be used to evaluate both intracranial and extracranial vascular lesions.
Laboratory Diagnosis
of Atherosclerosis
• Blood lipid examination: Dyslipidemia is an important risk factor for atherosclerosis. By detecting total cholesterol, triglyceride, low-density lipoprotein cholesterol and other indicators, the blood lipid level of patients can be assessed.
• Blood glucose and insulin resistance testing: Diabetes is one of the risk factors for atherosclerosis, and testing blood glucose and insulin resistance can help assess the risk of diabetes in patients.
• Inflammatory markers: The process of atherosclerosis is accompanied by an inflammatory response, and the detection of inflammatory markers such as C-reactive protein (CRP) can help assess the activity of the disease.
These diagnostic methods can help doctors diagnose atherosclerosis more accurately and make individualized treatment plans for patients.
Lifestyle intervention
• Healthy diet: Patients should adopt a low-salt, low-fat, low-calorie diet and increase the intake of fruits, vegetables, whole grains and healthy fats. Avoid eating too much saturated fat and cholesterol.
• Physical exercise: Regular and moderate aerobic exercise, such as walking, running and swimming, can help improve cardiovascular health and reduce the risk of atherosclerosis.
• Smoking cessation and alcohol restriction: Smoking cessation and alcohol restriction are essential for the prevention and treatment of atherosclerosis. Tobacco and alcohol have adverse effects on vascular health and should be avoided or reduced as much as possible.
Drug therapy
for atherosclerosis
• Lipid-lowering drugs: Statins are commonly used lipid-lowering drugs that are effective in lowering cholesterol levels and delaying the progression of atherosclerosis.
• Antiplatelet drugs, such as aspirin, can reduce platelet aggregation, prevent thrombosis and reduce the risk of cardiovascular disease.
• Antihypertensive drugs: For patients with hypertension, rational use of antihypertensive drugs, such as ACE inhibitors and ARBs, can help control blood pressure and reduce vascular damage.
