Atherosclerosis is the most common and important of a group of vascular diseases called arteriosclerosis.
[Etiology and pathogenesis].
The disease is a multi-causal disease, i.e., caused by multiple factors acting on different links, which are called risk factors or susceptibility factors.
The main risk factors are.
1, age, gender: the disease is clinically more common in middle-aged and elderly people over 40 years old, and progresses faster after 49 years old. The incidence is lower in males compared to females, but increases after menopause. Age and gender are unchangeable risk factors.
2. Dyslipidemia: the most important risk factor.
3, blood pressure: increased blood pressure is closely related to the disease.
4, smoking: and is proportional to the number of cigarettes smoked per day. Passive smoking is also a risk factor.
5, diabetes mellitus and abnormal glucose tolerance.
Secondary risk factors are also.
1, obesity.
2, those who engage in little physical activity, intense mental activity, and often have a sense of work urgency.
3, Western diet: often into higher calorie, containing more animal fat, cholesterol, sugar and salt food.
4, genetic factors: family members who suffered from the disease at a younger age, their close relatives may have five times the chance of getting the disease than families without such conditions.
5, impatient, competitive and competitive, not good at combining work and rest type A personality.
Other risk factors that have been identified in recent years include
1. elevated homocysteine in the blood.
2, increased insulin resistance.
3, increased fibrinogen and some coagulation factors in the blood.
4, viral and chlamydial infections, etc.
Clinical manifestations
Mainly the symptoms appear after the involvement of related organs.
1.General manifestations: brain and physical strength decline may occur.
2.Brain atherosclerosis.
3.Brain ischemia can cause vertigo, headache and syncope.
4.Brain atrophy causes dementia, with psychopathy, action disorder, intellectual and memory loss and even complete personality perversion, etc.
5, renal atherosclerosis: can cause intractable hypertension
6.Atherosclerosis of extremities.
The lower limb arteries are more common, causing coldness, numbness and typical intermittent claudication due to blood supply disorder, i.e. numbness, pain and even spasm of gastrocnemius muscle when walking, which disappears after rest and appears again when walking again; in severe cases, sustainable pain and weakening or disappearance of lower limb arteries, especially dorsalis pedis artery. If the arterial lumen is completely occluded, gangrene may occur.
Prevention and treatment
General prevention and control measures
(A) A reasonable diet
1, control the total dietary calories to maintain a normal body weight. The simple calculation of normal body weight is: body mass index = weight (kg) / height (m) 2, generally 20 to 24 as the normal range, for reference.
2.People who exceed the normal standard weight should reduce the total calories eaten daily, consume low-fat and low-cholesterol diet, and limit the intake of alcohol and sucrose and sugary food. Promote a light diet and eat more foods rich in vitamin C (such as fresh vegetables, fruits and vegetables) and vegetable protein (such as beans and their products). Try to use vegetable oil as cooking oil.
3.People over 40 years old should avoid eating too much animal fat and cholesterol-containing foods, such as fatty meat, liver, brain, kidney, lung and other offal, lard, egg yolk, crab yolk, fish roe, cream and its products, coconut oil and cocoa butter, even if they have no abnormal blood lipids. To consume low cholesterol, low animal fat food, such as fish, chicken, all kinds of lean meat, protein, soy products, etc. is appropriate.
4, has been diagnosed with coronary atherosclerosis, overeating is strictly prohibited, so as not to induce angina pectoris or myocardial infarction. Those who have hypertension or heart failure should limit salt at the same time.
(2) Appropriate physical work and physical activity
It is not advisable to force strenuous activities. For the elderly, it is recommended to take a walk (1 hour per day, can be divided), do health care gymnastics, play tai chi, etc.
(C) reasonable arrangement of work and life
Life should be regular. Maintain an optimistic and happy mood, avoid overwork and emotional excitement, pay attention to the combination of work and rest, and ensure sufficient sleep.
(D) advocate non-smoking, do not drink strong alcohol
Although a small amount of low-concentration wine can improve blood HDL, red wine has the effect of antioxidant, but long-term consumption will cause other problems, so it is not appropriate to promote.
Many scholars believe that preventive measures for this disease should begin in childhood, i.e. children should also not eat a diet high in cholesterol and animal fats, and should also avoid excessive intake to prevent gaining weight.
1.Drugs that mainly lower blood cholesterol and also lower blood triglycerides
2.Drugs that mainly lower blood triglycerides and also blood cholesterol
3.Niacin
It has the effect of lowering blood triglyceride and total cholesterol, increasing HDL and dilating peripheral blood vessels.
4.Bile acid compartmentalizer
It can lower the total blood cholesterol.
All of them need to be taken for a long time, and the dosage should be controlled and the side effects should be noted.
Anti-platelet drugs.