In the clinic, we often encounter patients with physical examination reports, saying, “Doctor, I have carotid plaque on my physical examination, should it matter? In fact, most patients do not need to be nervous because carotid plaque is more common in the middle-aged and elderly population. Objectively speaking, its potential harm is really great, but as long as the patient actively cooperates with the treatment, there is still hope to keep the plaque from harming the health. What is carotid plaque When multiple risk factors cause damage to the carotid artery vessel wall, there will be a clump-like structure formed by the aggregation of the subunits in the blood flow, which is called carotid plaque. In fact, carotid plaque is very common, with 45 out of 100 people over the age of 40 having carotid plaque and 84 out of 100 people over the age of 70 having carotid plaque. There are two types of carotid plaque, one is stable plaque and the other is unstable plaque, unstable plaque is easy to rupture and more dangerous. What are the dangers of carotid plaque? When the carotid plaque keeps increasing, it will cause narrowing of the carotid lumen and insufficient blood supply to the brain, resulting in dizziness, memory loss, blurred vision and tinnitus, etc. When the plaque reaches a certain level, it will rupture and then thrombus will form, blocking the blood vessel and causing stroke. Nearly 80% of stroke patients in China have carotid plaque. Risk factors for the formation of carotid plaque include hypertension, hyperglycemia, hyperlipidemia, advanced age and smoking, among which elevated LDL is the main culprit of carotid plaque formation. How to prevent and treat carotid plaque Most patients can be treated by lifestyle improvement + medication, while a small number of patients with large carotid plaque may need surgery. First of all, lifestyle improvement is the foundation, which requires reasonable diet, moderate exercise, smoking and alcohol cessation and balanced mentality; secondly, medication is the key, mainly antiplatelet, lipid regulating and antihypertensive treatment, and domestic and international guidelines unanimously recommend statin as the first choice of lipid-lowering treatment, which can effectively lower LDL and stabilize or reverse plaque. Some plaques also need surgical treatment if necessary, such as carotid artery stenosis greater than 70% in symptomatic patients or greater than 90% in asymptomatic patients, in which case carotid endarterectomy or carotid stenting can be considered. In conclusion, if carotid plaque is found, there is no need to worry too much, and standardized treatment can be provided in the cardiology department of the hospital to minimize or delay the harm caused by plaque.