atherosclerosis



OVERVIEW

Definition

Atherosclerosis is a condition in which the wall of the arterial blood vessels becomes less elastic and progressively “harder”.

Damage to the lining of the arterial wall causes pathological changes such as lipid accumulation, inflammation, and thrombosis, resulting in the formation of localized plaques. The appearance of plaque is yellow atherosclerosis, so it is called atherosclerosis.

Atherosclerosis is the most common pathological changes in cardiovascular and cerebrovascular system diseases, lesions mainly occur in the coronary arteries, carotid arteries, intracranial arteries, renal arteries, arteries of the lower limbs, the arteries of the fundus arteriosus and other parts of the body.

Classification

According to the vascular site where the lesion occurs, it can be divided into various types, and the common types are as follows:

Aortic atherosclerosis.

Coronary artery atherosclerosis.

Atherosclerosis of the renal arteries.

Atherosclerosis of the extremities.

Mesenteric artery atherosclerosis.

Pathogenesis

Pathologic changes may have occurred in the arteries during childhood, with significant pathologic changes or symptoms appearing only after middle age or old age.

It is most common in men over 40 years of age.

The male-to-female ratio is about 2:1, and the incidence increases in women after menopause.

Causes

Risk factors

There is no clear cause for this disease. The following factors increase the risk of atherosclerosis.

Age

Atherosclerosis is most common in people over 40 years of age and progresses more rapidly after the age of 49.

Sex

The ratio of male to female is about 2:1, and the incidence of the disease in women increases after menopause.

Dyslipidemia

Dyslipidemia is the most important risk factor for the disease.

Total cholesterol (TC) is elevated and triglycerides (TG) are elevated.

Low-density lipoprotein cholesterol (LDL-C) or very low-density lipoprotein cholesterol (VLDL-C) is increased. This is the main risk factor.

Increased apolipoprotein B (apoB).

High-density lipoprotein cholesterol (HDL-C) is decreased.

Decreased or elevated lipoprotein A.

Hypertension

Hypertension is strongly associated with coronary atherosclerosis.

People with high blood pressure have a 3 to 4 times higher risk of developing coronary heart disease (atherosclerotic heart disease of the coronary arteries) compared to people who do not have high blood pressure.

Smoking

The prevalence of this disease is 2 to 6 times higher in smokers than in non-smokers.

The higher the number of cigarettes smoked per day, the higher the morbidity and mortality rates.

“Second-hand smoke” (passive smoking) also increases the risk of morbidity and mortality from this disease.

Diabetes and abnormal glucose tolerance

The incidence of atherosclerosis is several times higher in people with diabetes compared to those without diabetes.

Overweight or obesity

People who weigh more than 20% of their standard body weight or have a BMI (body mass index) greater than 24 are at higher risk of developing this disease.

Family history

Relatives with atherosclerosis have a higher risk of developing the disease.

Genetic factors: atherosclerosis has a tendency to cluster in families.

“Type A personality”

People who are impatient, stubborn, and prone to anxiety and tension are at higher risk of developing the disease.

Oral contraceptives

Long-term use of oral contraceptives has a higher risk of developing the disease.

Poor dietary habits

Long-term high-calorie, high animal fat, high cholesterol, and high sugar diets have a higher risk of developing the disease.

Low physical activity

Sedentary lifestyle, low physical activity, and infrequent exercise are associated with a higher risk of developing the disease.

Pathogenesis

The pathogenesis of the disease is unclear, and there are theories or hypotheses such as the lipid infiltration theory, the endothelial damage-response theory, the platelet aggregation and thrombosis hypothesis, and the smooth muscle cell cloning theory.

Metabolic function abnormalities such as dyslipidemia, harmful substances such as nicotine, hypertension and other vascular abnormalities, etc., cause damage to the endothelium; cholesterol, inflammatory factors and cells, platelets and other substances in the endothelium of the damage to the accumulation of fibrous atherosclerotic plaques, so that the blood vessel elasticity is reduced, resulting in the formation of atherosclerosis.

Symptoms

Atherosclerosis may have no obvious symptoms in the early stage.

As the disease progresses, the atherosclerotic arteries may become narrowed or blocked, resulting in ischemia or necrosis and a variety of symptoms.

Symptoms may vary depending on the location of the disease.

Symptoms of aortic atherosclerosis

Symptoms occur when the aorta becomes occluded or narrowed.

They are mainly characterized by an increase in systolic blood pressure.

Aneurysm can be caused, and rupture of aneurysm can cause hemorrhage. Most of them die immediately, while a few mild ones show cold and clammy skin, unresponsiveness, pale skin, unconsciousness or coma.

Coronary atherosclerosis symptoms

Mostly obstruction or narrowing of the coronary arteries occurs, which can cause the following symptoms when coronary artery disease is caused.

Chest pain

Chest tightness.

Palpitations: manifested by feeling a rapid heartbeat, irregular heartbeat rhythm, and a sense of missed beats.

It can also cause heart failure and other diseases, fainting, coma and other symptoms, and sudden death can occur.

Carotid and intracranial atherosclerosis symptoms

Mostly symptoms that occur when the carotid arteries or intracranial arteries become narrowed or blocked, causing transient ischemic attack (TIA) or stroke.

Headache.

Vertigo: Feeling that you or objects around you are spinning, or feeling unsteady on your feet.

Fainting.

Memory loss.

Decreased mental ability.

Abnormal behavior and personality.

Hemiplegia.

Speech impairment.

Coma.

Symptoms of renal atherosclerosis

Symptoms that occur when the renal arteries become narrowed or blocked, causing reduced kidney function.

Increased blood pressure.

Increased nocturia.

Oliguria: a significant decrease in urine output.

Renal failure, intractable hypertension, increased urine output, decreased urine output, hematuria, urinary protein, blood pressure more than 140/90mmHg, or even higher, can also occur.

Symptoms of atherosclerosis of limbs

Symptoms occur when the arteries of the limbs are narrowed or blocked, causing peripheral arterial embolism.

Intermittent claudication: pain in the lower limbs during walking, claudication (limping), pain can be relieved or disappear after rest. When walking again, the pain reappears as lower limb pain and claudication.

The dorsalis pedis arterial pulsation is weakened or disappears.

It can also cause muscle atrophy, gangrene of the limbs, with symptoms such as decreased muscle strength, smaller muscles, thinner limbs, and broken skin.

Mesenteric artery atherosclerosis symptoms

Abdominal pain: mostly occurs about 10 minutes after eating, can gradually worsen, and relieved after about 1 hour.

Nausea.

Abdominal distension.

Diarrhea.

Constipation.

It can cause intestinal obstruction, intestinal infarction, etc. The presence of no gas, no bowel movement or bloody stool, severe vomiting, severe abdominal pain, etc. can be life-threatening.

Consultation

Department of Medicine

Cardiovascular Medicine

If atherosclerosis is detected during a routine physical examination, or if symptoms such as increased blood pressure, dizziness, or headache occur, it is recommended that you consult a doctor promptly.

Emergency Department

Sudden severe chest pain, severe palpitations, etc., it is recommended to go to the Emergency Department immediately.

In the event of loss of consciousness, respiratory and cardiac arrest, immediately call the 120 emergency number and perform CPR on the patient at the same time.

Preparation

Preparing for your visit: registration, information preparation, common problems

Tips for medical treatment: early clinical symptoms of atherosclerosis

Early clinical symptoms of atherosclerosis patients are not obvious, often found during physical examination, after the discovery of atherosclerosis need to consult a doctor in time to avoid the development of the disease.

Do not abuse drugs without the doctor’s permission, so as to avoid the drugs affecting the relevant examinations and interfering with the diagnosis and treatment of the disease.

Preparation checklist for seeking medical treatment

Especially need to pay attention to the time of occurrence of symptoms, special performance, etc.

Have you had dizziness or headache recently?

Have the symptoms worsened? Are there any obvious triggers?

Any other uncomfortable symptoms?

Is there a family history of the disease?

Have you had a recent physical examination? What are the results?

What is your diet? Is there any greasy diet, overeating?

Do you smoke or drink alcohol?

Any other diseases?

Results of the last six months, which can be brought to the doctor’s office

Blood test

Blood biochemistry

Urine routine

Liver and Kidney Function Tests

Lipid Profile

Vascular Ultrasound

CT Scan

Angiography

Medication in the last 3 months, if there is a medicine box or package, you can bring it to the doctor

Statin lipid regulators: lovastatin, simvastatin, atorvastatin

Cholesterol absorption inhibitors: ezetimibe

Other lipid regulators: Probucol

Betas: Fenofibrate, Benzafibrate, Gemfibrozil

Antiplatelet drugs: aspirin, clopidogrel, tigrilol

Anticoagulant and thrombolytic drugs: warfarin, rivaroxaban

Angina relief drugs: isosorbide nitrate, metoprolol

Drugs to improve cardiac remodeling: Benadryl, Captopril, Valsartan

Diagnosis

Diagnosis is based on

Medical History

Individuals with the following conditions are more likely to develop atherosclerosis.

Hyperlipidemia or dyslipidemia, hypertension, diabetes or glucose intolerance.

Have a history of smoking or are exposed to second-hand smoke.

Be overweight or obese.

Have a relative with the disease.

Have an impatient, stubborn personality and are prone to abnormal emotions.

Women often take oral contraceptives.

Long-term diet high in calories, animal fat, cholesterol and sugar.

Less exercise.

Clinical manifestations

Most people have no obvious manifestations, a few can present the following manifestations.

Symptoms: chest pain, chest tightness, dizziness, memory loss, limb weakness, oliguria, abdominal pain, intermittent claudication.

Signs: Systemic examination may reveal signs such as increased heart rate, decreased skin temperature of the lower limbs, decreased skin sensation of the lower limbs, decreased or absent dorsalis pedis arterial pulsation, abdominal pressure pain, and edema of the lower limbs due to atherosclerosis in different parts of the body.

Laboratory tests

Check liver function, kidney function, triglyceride, total cholesterol, LDL cholesterol, HDL cholesterol, blood glucose, cardiac enzymes.

It can clarify the risk factors and severity, and exclude other diseases.

Precautions: Fasting is required before the test, i.e., fasting for 6 hours and water fasting for 4 hours; no fasting is required for the emergency test.

It can understand the coagulation condition.

It can clarify the cause of the disease and exclude other diseases.

Imaging examination

It is the key basis for diagnosing atherosclerosis.

According to the clinical manifestations of the carotid artery, lower limb artery, renal artery and other parts of the examination.

Can clarify the location, scope and severity of atherosclerosis.

Precautions:

Check the coronary artery.

Can clarify the coronary artery lesions.

Precautions: Remove jewelry or metal objects, such as necklaces, from the examination area before the examination, and take off clothing made of metal.

Refresh

This is an angiogram that shows the condition of the blood vessels to see if there are any stenoses or aneurysms, as well as to clarify the severity of the condition.

Precautions:

It can clarify the functional and structural condition of the heart, especially the presence of segmental ventricular wall motion abnormalities.

Precautions:

Like DSA angiography, MRA can show blood vessels and detect diseases of the blood vessels, such as aneurysms, stenosis or occlusion of blood vessels, and vascular malformations.

It is mainly used for cerebrovascular examination.

Precautions:

Electrocardiogram

By examining the electrical signals of the heart.

It can clarify the heart rhythm, the presence of ischemia, infarction and other conditions.

Precautions:

Stress test

To understand the function of the heart by measuring the electrocardiogram during exercise such as walking on a treadmill or riding a motorized bicycle.

Precautions: Follow the doctor’s request for activities during the test; inform the doctor promptly if there is any discomfort.

Differential Diagnosis

Different parts of the atherosclerosis, need to identify different diseases. For example, thoracic segment is mainly identified with mediastinitis and aortitis, coronary artery is mainly identified with heart disease, carotid artery and intracranial artery atherosclerosis need to be identified with cerebral vascular malformation, intracranial tumors and so on, and renal artery, mesenteric artery, lower limb artery and so on have their own need to be identified with the disease.

Aortic Atherosclerosis

Similarities: Aortic lesions can cause abnormal blood flow.

Differences: Aortic aneurysms can rupture and cause severe bleeding. It can be differentiated by electrocardiogram, vascular ultrasound, and angiography.

Similarities: Aortic morphologic changes.

Differences: Mediastinal tumors are tumors that occur in the mediastinum and can compress the aorta, nerves in the mediastinum, etc. It can be differentiated by electrocardiogram and chest CT.

Similarity: structural abnormality of the aorta.

Differences: Syphilitic arteritis is an infectious disease caused by syphilitic spirochetes, which mostly occurs in the late stage of syphilis. It can be differentiated by blood routine, C-reactive protein, virology, ECG and other tests.

Coronary atherosclerosis

Similarities: chest pain, chest tightness, palpitations.

Differences: Coronary arteritis is an inflammation of blood vessels caused by autoimmune factors, and may present with fever and other symptoms. It can be differentiated by laboratory tests, electrocardiogram and coronary CT.

Similarities: Chest pain, chest tightness, palpitations.

Differences: Coronary embolism is a disease caused by blockage of coronary arteries due to air, fat and blood clots. It can be differentiated by coronary artery CT.

Similarities: Chest pain, chest tightness, palpitations.

Differences: Myocarditis is a disease caused by infection, autoimmune factors and other causes of myocardial cell damage, coronary artery may not have obvious lesions. It can be differentiated by blood tests, C-reactive protein, electrocardiogram and other tests.

Similarities: Chest pain, chest tightness, palpitations.

Differences: Cardiomyopathy is a cardiomyocyte lesion caused by congenital factors, autoimmune factors, etc. Coronary arteries may have no abnormalities. It can be differentiated by ECG, echocardiography and other tests.

Carotid and intracranial atherosclerosis

Similarities: Vertigo.

Differences: Cerebrovascular malformations are mostly caused by congenital factors and may be asymptomatic or present with stroke-like symptoms. They can be identified by vascular ultrasound and angiography.

Similarities: vertigo, headache, hemiplegia, slurred speech, etc.

Differences: Intracranial tumors can be metastasized to the skull from other parts of the body or be primary intracranial tumors. Tumor compressing brain tissues and blood vessels can present corresponding symptoms. Symptoms can be relieved after tumor removal. It can be identified by head CT, head MRI and other examinations.

Similarities: vertigo, headache, confusion, etc.

Differences: Intracranial infection is a neurological disease caused by bacterial and viral infections, and it will also present with fever, cough, sputum and other symptoms. Blood vessels are mostly without obvious lesions. It can be distinguished by blood routine, cerebrospinal fluid examination, head CT and other examinations.

Renal Atherosclerosis

Similarity: elevated blood pressure.

Differences: Congenital renal artery stenosis is a disease caused by congenital developmental abnormalities, most of which occur at birth. It can be differentiated by renal artery ultrasound and renal arteriography.

Similarities: Low back pain, hematuria.

Differences: Kidney stones are abnormal crystallization in the kidney caused by metabolic abnormalities, which can be manifested by lumbar cramps and debris in the urine. Renal arteries are mostly without obvious lesions. It can be differentiated by renal ultrasound and other examinations.

Similarities: low back pain, hematuria, etc.

Differences: Renal tumors are benign or malignant tumors occurring in the kidney. Renal arteries are mostly without obvious lesions. It can be differentiated by renal ultrasound, renal CT or enhanced CT.

Similarities: low back pain, elevated blood pressure.

Differences: adrenal disease with primary aldosteronism and adrenal tumors can cause similar symptoms, but renal arteries are mostly without obvious lesions. It can be differentiated by serum hormone testing, adrenal ultrasound and other tests.

Atherosclerosis of the extremities

Similarities: lower limb pain, intermittent claudication, etc.

Differences: Multiple aortitis is related to autoimmune function abnormality and often involves large arteries throughout the body. It can be differentiated by C-reactive protein and vascular ultrasound.

Similarities: lower extremity pain, intermittent claudication, decreased skin temperature, weakened dorsalis pedis arteries.

Differences: Thrombotic occlusive arteritis of the lower extremities is a disease caused by blood clots leading to obstruction of blood vessels. There may be no obvious abnormality in the vessel wall. It can be differentiated by C-reactive protein, vascular ultrasound, and angiography.

Similarities: lower limb pain, intermittent claudication.

Differences: Lower extremity venous thrombosis is a disease caused by obstruction of the veins leading to impaired blood return, and may also present with lower extremity edema, skin bruising, etc. The arteries of the lower extremities are usually not obvious. The arteries of the lower limbs are often without obvious lesions. It can be differentiated by vascular ultrasound and angiography.

Mesenteric artery atherosclerosis

Similarities: Abdominal pain, abdominal distension, diarrhea, etc.

Differences: Mesenteric artery embolism is a disease caused by blood clots and other blockages of blood vessels. There may be no obvious abnormality in the wall of the blood vessel. It can be differentiated by abdominal enhancement CT.

Similarities: abdominal pain, bloating, vomiting, no gas, no bowel movement.

Differences: In intestinal obstruction caused by feces, foreign bodies, etc., there is no obvious abnormality in the wall of mesenteric artery vessels. It can be differentiated by standing abdominal radiographs.

Similarities: abdominal pain, abdominal distension, etc.

Differences: Peptic ulcer is a complication of gastric ulcer and duodenal ulcer, abdominal pain can be cut-like, and mesenteric artery has no obvious lesions. It can be differentiated by routine blood tests, standing abdominal radiographs, and abdominal CT.

Similarities: abdominal pain, abdominal distension, nausea, diarrhea and so on.

Differences: Enterocolitis is an inflammation of the intestinal tract caused by infection, autoimmunity, etc., and mesenteric arteries are mostly without obvious abnormalities. It can be distinguished by blood routine, C-reactive protein, fecal routine, fecal culture and other tests.

Treatment

Purpose of treatment

To control the disease in time, slow down its progress, protect organs and reduce the risk of serious conditions.

General treatment

Improve diet

Low-fat diet, vegetable oil can be used for cooking, and no more than 25 grams per day; try to eat less animal offal which contains a lot of cholesterol, and reduce the intake of saturated fat such as fatty meat, animal oil and other animal fats.

If you are deficient in vitamin B6, vitamin B12 and vitamin C, you should take dietary supplements under the guidance of your doctor.

Appropriately increase the intake of protein, unsaturated fats (such as deep-sea fish, a small amount of nuts, etc.), vitamins, minerals, fiber, and water.

Avoid cooking methods such as frying and grilling.

If there are other comorbidities, the diet should take care of the following conditions:

Improve lifestyle habits

Quit smoking and stay away from second-hand smoke.

Maintain good work and rest habits, regular work and rest, ensure enough sleep, avoid staying up late.

Exercise in moderation

Choose the exercise that suits you, or choose the exercise program according to your doctor’s requirements.

Avoid being sedentary.

Weight control

Keep your weight within the normal range by improving your diet, lifestyle habits, and exercising in moderation, and keep your Body Mass Index (BMI) at 18.5 to 23.9.

Stress Relief

Avoid bad emotions such as tension, anxiety, depression and anger.

Treat diseases

Actively treat the diseases you already have, such as hyperlipidemia, hypertension and diabetes.

Medication

Regulate blood lipids

Regulate blood lipids by lowering total cholesterol, LDL cholesterol, etc. to slow down the progression of the disease.

Commonly used drugs include statins (e.g. simvastatin, atorvastatin), fibrates (e.g. fenofibrate), ezetimibe, PCSK9 inhibitors (e.g. eloxacinumab).

Adverse reactions include hepatic impairment, rhabdomyolysis, and gastrointestinal upset.

Liver function should be checked before medication and periodically during treatment.

Antiplatelet therapy

It can inhibit platelet adhesion and aggregation and reduce the risk of thrombosis.

Commonly used drugs include aspirin, clopidogrel, and tegretol.

Adverse reactions include gastrointestinal discomfort and gastrointestinal bleeding.

Anticoagulation and thrombolytic therapy

It can prevent and control blood clots and dissolve blood clots.

It is used when there is already thrombosis in the artery and there is narrowing or blockage of the lumen.

Anticoagulants include heparin, low molecular weight heparin, warfarin, dabigatran etexilate, and rivaroxaban.

Thrombolytic drugs include streptokinase, urokinase, alteplase, etc.

Adverse effects include easy bleeding, etc.

Relief of angina pectoris

Improve the symptoms of angina or prevent attacks by dilating blood vessels and reducing myocardial oxygen consumption.

Commonly used drugs include vasodilators (e.g. isosorbide nitrate) and beta-blockers (e.g. metoprolol).

Watch for adverse effects such as hypotension.

Improvement of cardiac remodeling and prognosis

It can improve the repair function of the myocardium, improve the therapeutic effect and delay the progression of the disease.

Commonly used types of drugs are angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor antagonists (ARB) drugs.

Commonly used ACEI drugs include Benadryl, Fosinopril, Captopril, etc.; commonly used ARB drugs include Chlorosartan, Valsartan, etc.

Adverse reactions include irritating dry cough, abnormal taste and allergy.

Proprietary Chinese medicines

It is mainly used to activate blood circulation and eliminate blood stasis, which can improve the symptoms.

Blood lipids Kang capsule, Di Ao heart blood Kang capsule, gynostemma total glycoside tablets, etc. can be used.

Specific drugs should be used in accordance with the doctor’s requirements to avoid aggravation of the condition caused by self-medication.

Interventional therapy

Treatment methods include percutaneous intracavitary balloon dilatation, atheromatous plaque laser rotary dissection, and stent implantation.

The areas that can be treated include the coronary arteries of the heart, renal arteries, carotid arteries, superior mesenteric arteries, and so on.

The treated balloon and stent are delivered to the diseased blood vessel through the blood vessel at the root of the wrist or thigh, propping up the blood vessel, maintaining blood flow to the vessel and ensuring blood supply to the tissue.

It is one of the commonly used treatments nowadays, and can be used for thrombolysis, filter placement, and stent implantation in the acute stage, as well as when the condition is stabilized.

Surgical treatment

Indications

Surgery is required when the condition is severe and cannot be improved by other treatments.

Surgical Procedures

These include coronary artery bypass grafting (also known as bypass grafting) and carotid endarterectomy.

Bypass grafting takes a section of blood vessel from a healthy part of the body and connects it directly from a large blood vessel to a normal blood vessel in the lower part of the diseased area, bypassing the diseased area, to ensure blood supply to the tissues and to maintain the normal function of the organs.

Precautions after surgery

After bypass grafting

Nutrients such as protein, unsaturated fat, vitamins, minerals and dietary fiber should be increased.

Fluid food, semi-liquid food, and food that is highly nutritious and easy to digest and absorb should be chosen according to the doctor’s requirements.

Low fat and low cholesterol diet should be taken, avoiding foods such as fatty meat, cream, animal offal, egg yolk, mollusks (squid, cuttlefish).

Avoid spicy and stimulating foods.

Move around as required by your doctor and avoid excessive activity or too much time in bed.

Avoid pulling the surgical wound when moving.

Protect the surgical wound when eating, turning over and moving around.

Avoid excessive force or sudden force that may cause the wound to split.

Change the medication regularly according to the doctor’s requirements.

If there is bleeding, severe pain, redness or swelling of the wound, consult a doctor promptly.

Traditional Chinese Medicine (TCM)

Doctors will choose targeted treatments according to the condition (Diagnostic Therapy). The methods that may be used are mainly tonics.

TCM treatment should be carried out in regular hospitals, avoiding unidentified treatments such as local remedies, secret prescriptions, and biased remedies.

The tonics that may be used include the addition and subtraction of phlegm-conducting tonics, the addition and subtraction of blood-fu chasing blood stasis tonics, and the addition and subtraction of six-flavored dihuang pills.

Prognosis

Cure

The disease cannot be cured.

The progression of the disease can be slowed down with prompt treatment, reducing the risk of serious conditions or serious complications.

In more severe cases, long-term treatment can relieve symptoms and improve quality of life.

Hazards

Aortic atherosclerosis can cause complications such as aortic aneurysms, which can rupture and cause bleeding that can be life-threatening.

Coronary atherosclerosis can cause angina pectoris, which affects daily life and reduces quality of life; it can also cause acute myocardial infarction and acute heart failure, which is life-threatening.

Atherosclerosis of carotid and intracranial arteries can cause memory loss, mental retardation, etc., affecting the quality of life; it can cause stroke, hemiplegia, slurred speech, affecting the quality of life, and can be life-threatening in severe cases.

Renal artery atherosclerosis can cause kidney failure, intractable hypertension, edema, elevated blood pressure, dizziness, headache and other symptoms, so that the quality of life is reduced; renal failure is serious when dialysis treatment is needed, and the range of activities is limited; renal failure is serious if not treated in time, death can occur, even sudden death.

Atherosclerosis of the extremities can cause intermittent claudication, which affects activity and reduces quality of life.

Mesenteric artery atherosclerosis can appear abdominal pain, diarrhea, etc., affecting the diet; it can also cause intestinal obstruction and intestinal infarction, which can be life-threatening in severe cases.

Daily

Daily Management

Diet management

Avoid overeating, reduce weight appropriately and maintain healthy weight.

Low-fat diet should be adopted to reduce the intake of fatty meat, fried food and snacks.

Increase protein, unsaturated fat, vitamins, minerals, dietary fiber. Fish, soy products, skimmed milk, egg whites, fresh fruits (fruits with low sugar content are appropriate), fresh vegetables, nuts can be chosen.

Reduce refined rice and noodles, and choose corn, millet, white potatoes, yams and other alternatives to staple foods.

Avoid high-sugar foods such as sugary drinks, snacks, and overly sweet fruits.

Control the intake of high cholesterol foods.

Lifestyle management

Regular work and rest, ensure adequate sleep and avoid staying up late.

Avoid over-exertion.

Quit smoking and avoid passive smoking.

Adhere to moderate exercise, exercise at least 30 minutes a day, you can choose fast walking, jogging, cycling, swimming, playing tai chi and so on. Or follow the doctor’s requirements to choose the exercise time and exercise program.

Pay attention to safety when exercising and avoid excessive exercise.

If you feel unwell during exercise, stop exercising immediately.

Emotional management

Avoid negative emotions such as tension, anxiety, anger and depression.

Relieve stress by listening to soft music, chatting with friends and relatives, reading books and watching soothing movies and TV dramas.

In serious cases, you can go to a formal psychological counseling agency for consultation and treatment.

Safety management

If vertigo occurs, sit or lie down immediately to avoid falling.

If there is hemiplegia, weakness of lower limbs, etc., you should choose crutches, walking aids, etc. to move around, or be supported by family members or pushed by wheelchair.

Regular review

Follow your doctor’s instructions for regular checkups.

Measure your blood pressure and blood sugar at home.

Seek timely medical attention

If symptoms do not decrease or worsen, or if new symptoms appear, consult a doctor.

Prevention

Adjust diet, ensure balanced nutrition, maintain appropriate body weight, avoid diets high in salt, fat and sugar, and consume more foods rich in dietary fiber, such as whole grains, fresh fruits and vegetables.

Exercise regularly and avoid sedentary lifestyle.

Quit smoking and avoid passive smoking.

Quit drinking or drink in moderation, avoid alcoholism.

Maintain a positive mindset and avoid bad emotions such as stress, anxiety and anger.

Actively treat physical diseases, such as hypertension, diabetes, hyperlipidemia.

Have regular medical checkups, and seek timely consultation and treatment if abnormalities are found.