In recent years, there are more and more patients with carotid atherosclerosis and plaque formation. In addition, with the gradual improvement of people’s health awareness, more and more people start annual routine medical checkups, and carotid vascular ultrasound is slowly being added to the routine medical checkup programs (at present, there are still a lot of places or units that do not make carotid vascular ultrasound a routine medical checkup program), and it is precisely because of the improvement of people’s health awareness and the popularity of carotid vascular ultrasound in medical checkups that the detection rate of carotid arteriosclerosis and plaque formation is also increasing. The detection rate is also increasing. Many patients who find carotid atherosclerosis and plaque for the first time are wondering how the carotid blood vessels harden and grow plaque when they are usually in good health and have no dizziness and other discomforts. In fact, with the improvement of modern people’s living standard, the daily dietary intake of salt, fat, sugar more and more, coupled with physical activity to reduce the metabolism slows down after ageing, atherosclerosis of the onset of age is also gradually younger. 1. Is it serious to detect carotid atherosclerosis and plaque formation? Patients with carotid atherosclerosis and plaque formation do not necessarily have obvious clinical symptoms, only when the plaque increases to a certain extent causing blood vessel narrowing, which in turn leads to insufficient blood supply to the brain will appear dizziness, lightheadedness and other discomfort. When the plaque increases to a certain degree and causes blood vessel narrowing, the patient’s symptoms are not only dizziness and other discomforts, but also transient ischemic attack (TIA) due to severe cerebral ischemia, e.g., sudden speech is unclear, mouth is crooked, and one side of the arms and legs are numb and weak, etc. The above symptoms last for a few seconds to a few hours, and then the patient’s symptoms can be recovered completely, therefore, we call it transient ischemic attack (TIA). At this time, the patient’s symptoms can still be fully recovered, so we call it transient ischemic attack (TIA), but if we can’t improve the cerebral ischemia with timely treatment at this time, it will further develop into irreversible acute cerebral infarction. Therefore, when carotid artery atherosclerosis and plaque formation in the early stage (at this time the plaque is small) has not caused significant narrowing of blood vessels, the condition is not serious, and do not have to worry too much about it, and generally will not occur in cerebral infarction and other serious cerebrovascular diseases. However, the condition is not serious does not mean that we do not have to pay attention to it, because at this time, if we do not pay attention to it and do not actively treat it, the carotid plaque will grow bigger and bigger, and when the plaque is very big and then go to treat it, we will lose the best time to treat it. 2.How to prevent and treat? Let’s talk about prevention, from the carotid atherosclerosis and plaque formation of the name of this disease can be seen, in the process of this disease is generally the first carotid atherosclerosis, followed by the slow growth of plaque. Therefore, in the final analysis, our prevention of this disease is to prevent the occurrence of atherosclerosis. First of all, let’s take a look at the common risk factors that cause and aggravate atherosclerosis: age (the incidence of the disease increases with age), gender (men are more likely to be affected than women), genetic factors (atherosclerotic diseases such as coronary heart disease and cerebral infarction in the father and mother increase the risk of the disease in their children), a diet high in salt, high in fat, high in sugar, hypertension, diabetes mellitus, hyperlipidaemia, smoking, drinking, lack of physical activity and exercise, and so on. Knowing the above risk factors, the prevention of carotid atherosclerosis and plaque formation focuses on the intervention of the above risk factors. Of course, some of the above risk factors cannot be intervened, such as age and gender, which we cannot intervene; and genetic factors, which we cannot intervene. But some other risk factors can be intervened in our daily life, usually pay attention to low-salt and low-fat diet, control sugar intake, actively control hypertension, diabetes mellitus, hyperlipidemia, quit smoking, limit the consumption of alcohol, and usually more exercise. If the risk factors are well controlled, the incidence of carotid atherosclerosis and plaque formation will be significantly reduced. Of course, atherosclerosis is inevitable in the elderly at any time when people’s age is increasing, but plaque size is controllable by controlling risk factors. For patients who have already developed carotid atherosclerosis and plaque, the same emphasis should be placed on controlling the above risk factors as well as active treatment. For patients who only have carotid atherosclerosis and no plaque formation, it is enough to improve the living habits and control the above risk factors, at this time, there is no need to carry out drug treatment for carotid atherosclerosis, remembering that patients who are combined with hypertension, diabetes mellitus and hyperlipidemia should actively control the original disease. For patients with plaque formation, we should actively carry out treatment, including drug treatment and surgical treatment (carotid endarterectomy or stent placement). Generally, patients with small plaques and no serious stenosis should be treated with medication, including statins, such as atorvastatin calcium tablets, resuvastatin calcium tablets, pitavastatin calcium tablets or pravastatin calcium tablets, etc. At the same time, it is necessary to take into account the actual size of the patient’s plaques and the presence or absence of other diseases, such as cavernous cerebral infarction, coronary artery disease, etc., and to decide whether to combine the application of antiplatelet aggregation medication, such as: Aspirin or Clopidogrel. For patients with large plaques and stenosis greater than or equal to 70%, it is recommended to actively undergo surgical treatment, because at this time, due to the severity of stenosis, the risk of sudden occlusion of blood vessels is higher, and once the occlusion occurs, the consequences are generally very serious (large cerebral infarction). Importantly, it is important to remember not to take medication on your own and casually reduce or stop medication, as each patient’s specific condition is different, and the specific treatment plan should be decided by the competent doctor according to the patient’s condition and whether there is any combination of other diseases. 3.What are the precautions in daily life? For daily precautions, improving lifestyle and controlling risk factors as mentioned above are very important and should be emphasized. In addition, it is important to avoid neck massage and other treatments, which may lead to carotid plaque detachment or carotid artery entrapment, which is very dangerous when it occurs. At the same time, patients with carotid atherosclerosis and plaque formation should pay attention to regular annual physical examination and dynamic observation of carotid artery atherosclerosis and plaque changes, so as to achieve a good understanding of the condition of the changes in time for treatment.