What is plaque began to fall?Late

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What is plaque began to fall?Late

2022-01-13 12:04:48 40 ℃


Studies have shown that low-density lipoprotein, LDLs and other lipoproteins containing apolipoprotein B (APOB) have played an important role in the development of atherosclerosis cardiovascular disease, so maintaining the most Good blood fat levels are essential to cardiovascular health [1].


How does blood fat affect the cardiovascular system? What is the ideal optimum blood lipid level? Let us look at the top magazines in the cardiovascular field - US Heart Society Magazine (JACC) Previous study of blood lipids on the impact of blood-vascular systems.

Image Source: JACC

LDL and other less than 70 nm of APOB-containing lipoproteins can be used through the endothelium barriers and interact with protein polysaccharides outside, thereby retaining the lipoproteins retained under the arterial wall can cause complex biology. Reaction, thereby causing atherosclerosis. Over time, more and more lipoprotein gatherings lead to the gradual increase in atherosclerotic plaques, these plaques can eventually break the formation of thrombus-blocking blood flow leads to acute cardiovascular events such as angina, myocardial infarction. .

So how do I evaluate the risk of a person to form an atherosclerotic plaque? This has to mention the atherosclerosis load.

The formation of atherosclerotic plaques depends on:

Circulating LDL and other apoB-containing lipoprotein levels

Exposure to these lipoproteins

Since 90% of APOB-containing lipoproteins are LDL, while LDL is directly measured, low-density lipoprotein cholesterol, LDL-C is used to estimate the level of LDL in the cycle, so I can use LDL -C Level × Age Roughly estimated a person's atherosclerosis load.

Let us take a few charts to observe the influencing factors and characteristics of the LDL-C level.


The relationship between atherosclerosis load and the risk of cardiovascular disease. Exceeding the accumulated LDL-C threshold, myocardial infarction is increased over time:


The low-density lipoprotein level retains less lipoprotein under the arterial wall, so the growth rate of the plaque is slower, maintaining a lower blood lipid level in the individual life, minimizing low density lipoprotein and other apob The accumulation exposure of lipoprotein may significantly change the process of arterial hardness plaque, and greatly reduce the life of cardiovascular events:


Reduce primary and first-level prevention: about half of the concentration of low density lipoprotein and other APOB-containing lipoprotein particles in one cycle is genetically inherited, and the other half is obtained through diet and lifestyle.

In the early stage of life (children and adolescents), the primary prevention strategy of LDL-C exposure can be fundamentally prevent blood lipid levels. Reduce blood lipids to a primary prevention strategy for the early adulthood, minimizing the total accumulation of atherosclerotic lipoproteins:

The optimum lipid level for redefining ideal cardiovascular health is LDL-C 1.8 mmol / L or 2.0 mmol / (70 mg / dl or 80 mg / dl).

Incidental ultrasound research data showed that atherosclerotic plaques stopped progress in LDL-C was 1.8 mmol / L (70 mg / dl). Therefore, the LDL-C level is 1.8 mmol / L (70 mg / dl) may be the threshold of the optimal blood lipid level. Further, from Fig. 2, it can be seen that LDL-C is 2.0 mmol / L (80 mg / dl) or a threshold for the optimum blood lipid level.


Blood lipids are affected by genetics, and some of the same plasma LDL-C concentrations can easily reserve atherosclerosis albumin can accumulate plaques faster, and some people may benefit from early and more active treatments:


Early lowerphase will slow down the progress rate of atherosclerotic plaques and reduce the risk of cardiovascular events:

For people from 50 to 70 years, low 1.0 mmol / l (40 mg / dl) LDL-C can reduce myocardial infarction by 25%, while the LDL-C which remains low in the whole life will be lower than advanced. Gain a bigger.


The clinical benefits of long-term LDL-C are approximately three times the short-term intervention, and these particles also have accumulated effects on the risk of cardiovascular disease over time, maintaining an ideal lipid throughout the year. The level is more effective than reducing LDL after plaque progression:

This also tells us that diet control is the safest and most effective way to achieve the best lipid level.

Compared with exercise, the effect on LDL and other apoB-containing lipoprotein levels is larger, and the plasma LDL-C level can be reduced by reducing the intake of saturated fat. Starting from the childhood, it is preferentially achieving a healthy diet to slow the progress of atherosclerosis. For LDL genetic load, the blood lipid level is higher than the optimal threshold, and imaging shows a large number of plaque load or plaque rapid progress. Early adulthood received lipid-lowering intervention. Expert Review

This review describes the accumulation of lipoproteins to cardiovascular disease risk, and the risk of cardiovascular disease depends on circulating LDL and other apoB levels and exposure to these lipoproteins. From the early stage, the good lipid level controlled in the whole life cycle can reduce the speed of atherosclerosis plaque, which can significantly reduce the lifelong risk of atherosclerosis cardiovascular disease.

In the past 30 years, the level of blood lipids in the Chinese population has gradually increased, and the prevalence of blood lipid is significantly increased. In 2012, the results of the National Survey show that China's adult blood lipid abnormal prevalence is as high as 40.40%, and the rise of serum cholesterol levels in population will lead to approximately 9.2 million cardiovascular events during 2010 ~ 2030. It is predicted that China's adult blood lipid abnormal disease and related disease burden will continue to increase [2].

For the Chinese people, the prevention and treatment of blood lipids and the atherosclerosis heart disease is still heavy and far, the blood lipid abnormal knowledge is low, and the presence of drugs in traditional statins is not tolerated, and the patient's compliance is poor. Difficulty. With the emergence of new drugs, such as small interfering nucleic acids (siRNA) drugs, new ideas provide blood lipid control for patients with blood lipid abnormal blood lipid abnormalities in my country. For example, the two-needle-in-neck-injected includeiran can help with patients with poor and smooth fat.

In addition to the drug, more importantly, it should improve the importance of the people's abnormal blood lipids and encourage people to take healthy lifestyle. Early with diet, drugs maintain blood lipids lower levels to reduce the risk of cardiovascular events.

Expert resume

Zhao level

Professor, doctoral tutor

Chief Physician of the Cardiovascular Internal Medicine First Cardiology, Xiangya Second Hospital of Central South University. Mainly engaged in the study and clinical work of abnormal blood lipid metabolism and coronary heart disease. Opened blood lipids in China. In 2007, he was rated as a national high-tech contribution to the Ministry of Health.

The edited monographs 39, of which "Clinical Hematopartysis" has been funded by the National Press and Publication Fund and won the Ministry of Health Science and Technology Achievements Award. Enjoy the State Council has highlighted contribution to experts. He is currently a member of the Asia-Pacific Academy of Atherry Hardens; Deputy Director of the Cooperation of Cardiovascular Branch of the Chinese Medical Association; member of the Cardiological Prevention and Control Economic Detective Committee of the Chinese Medical Association. Serving the Chinese Journal of Cardiovascular Diseases, Chinese Medicine Magazines. Since 1998, the national medical continuing education is hosted by national medical continuing education. More than 700 scientific research papers have been published, including 161 SCI papers. 110 students and doctoral students.

Content planning: Gao Jie

Project review: Sun Nan

Source: Station Cool Heilo


[1] .erence Ba, Graham I, Tokgozoglu L, Catapano Al. Impact of Lipids On Cardiovascular Health: JACC Health Promotion Series. J Am Coll Cardiol. 2018 Sep 4; 72 (10): 1141-1156. Doi: 10.1016 / J. Jacc.2018.06.046. Pmid: 30165986.