The carotid artery is anatomically divided into three layers: the outer membrane, the middle layer and the inner membrane. Normally, the sum of the intima and middle layers of the carotid artery does not exceed 0.9 mm; if the thickness of both exceeds 0.9 mm on ultrasound, the intima is said to be thickened. Many causes can cause carotid intima thickening, and the most common cause is atherosclerotic lesions. The pathophysiological process is as follows: cholesterol in the blood enters the subintima, where it collects and undergoes a series of complex changes such as inflammatory reaction (different from what the common people call bacterial infectious inflammation), forming early atherosclerotic lesions. At this time, if not controlled, such as high blood pressure, high blood pressure, smoking, high blood sugar, etc., cholesterol will accumulate here in large quantities, causing further thickening of the carotid intima. When its thickness exceeds 1.3 mm, it is clinically diagnosed as carotid plaque formation. If the plaque continues to grow, it will lead to narrowing of the carotid artery lumen, resulting in reduced or even interrupted blood supply to the carotid artery, which can lead to cerebral infarction in severe cases. To use an analogy, it is like the thickening of scale in a water pipe, which eventually blocks the water pipe. Treatment of carotid intima-media thickening Simple carotid intima-media thickening should not require drug treatment, but it should be taken seriously. Because the carotid artery is a “window” to the systemic arterial system, it can indirectly reflect the possibility of atherosclerotic lesions in other parts of the arteries (such as intracranial arteries, coronary arteries, etc.). Studies have found that people with carotid plaque or stenosis are more likely to suffer from coronary heart disease and stroke. Therefore, early detection and treatment of risk factors such as hypertension, hyperlipidemia, smoking, diabetes, and obesity can help avoid or delay the onset and progression of carotid intima-media thickening. When carotid intimal thickening forms a plaque and leads to significant carotid stenosis (≥50% stenosis), the treatment is the same as that for coronary heart disease or ischemic stroke and should be treated immediately with statins such as atorvastatin and resulvastatin to control LDL-C below 1.8 mmol/L. In addition, most patients should receive antiplatelet therapy with aspirin. If the carotid plaque does not lead to significant stenosis (<50% stenosis), the patient needs to be evaluated for the presence of cardiovascular disease or other cardiovascular risk factors. The specific one requires a comprehensive judgment by the cardiologist based on the patient's condition.