What to drink with atherosclerosis of the brain. Drugs for the treatment of cerebral atherosclerosis: choose the most effective. Tablets from ischemic syndrome

What drugs for cerebral atherosclerosis should be used during the treatment of the disease? Atherosclerosis is vascular pathology caused by lipid metabolism disorders. From this disease older people (over 50 years old) are more often affected. This disease has a lot social significance due to the risk of stroke, disability and possible lethal outcome. Atherosclerosis of cerebral vessels often leads to hypertension, the formation of blood clots. What is atherosclerosis of the vessels of the head, what is its treatment?

Folk methods of treatment

Restenosis was significantly lower in cilostazol-treated diabetics in small vessels, in large lesions, and in lesions located in the anterior descending artery. There was no difference in risk of bleeding, hospital reinvestment, target vessel revascularization, myocardial infarction, or death.

Cilostazol treatment resulted in a significant minimum lumen diameter and a significantly lower rate of restenosis compared to placebo. These effects were also evident in patients with high risk development of coronary restenosis, such as diabetics, and patients with atherosclerotic disease in small vessels, and were similar in most of the subgroups assessed.

Features of atherosclerosis of cerebral vessels

Often atherosclerosis affects the blood vessels of the brain. The disease is characterized by the deposition of lipids on the walls of blood vessels, followed by the formation of atherosclerotic plaques. The latter reduce the lumen of the vessels, contribute to the traumatization of the wall. This leads to the formation of blood clots. Main etiological factors are:

There was no acute thrombosis coronary arteries in the first 24 hours or subacute between 24 and 30 days. Quantitative follow-up coronary angiography was performed in 154 patients at 6.7 months and showed that intrapotential restenosis occurred in 5.3% of the cilostazol group and 13.3% of the clopidogrel group. The minimum coronary lumen diameter was 2.84 ± 0.56 mm in the cilostazol group and 2.68 ± 0.61 in the clopidogrel group. Late luminal loss was 0.32 ± 0.18 mm in the cilostazol group and 0.37 ± 0.31 in the clopidogrel group.

Vitamins and sequestrants

We included 400 patients with angina pectoris, a non-invasive test provoking positive ischemia and native coronary artery injury 50 50% with a reference diameter of 2.5 mm. Patients with left coronary artery disease and left ventricular ejection fraction were excluded. Treatment of diabetes in both groups did not differ: only 10% diet, 75% used oral hypoglycemic agents and 16% insulin. Treated vessels were: anterior descending, 60% rounded, 13% right coronary, 26%.

smoking;
alcohol abuse;
excess animal fats and lack of vitamins in the body;
Availability ;
sedentary lifestyle;
blood diseases;
increased blood clotting;
stress;
hereditary factor.

Predisposing factors include overweight the presence of a history of diabetes mellitus in a person. With damage to the vessels of the brain, the following are possible clinical symptoms: decreased working capacity and memory, paresthesia, headache, weakness, development of depression, nervousness. These manifestations are characteristic of early stage diseases. During the height of the disease, delirium may appear. With a progressive course of atherosclerosis, the development of dementia (dementia) is possible. During this period, paresis and paralysis of the limbs often develop. It makes it much harder for you to take care of yourself. Most frequent complication is the development of stroke and transient ischemic attacks.

Follow-up angiography was performed in 82% of patients within six months. The need for target vessel revascularization was lower in the cilostazol group. In both groups, the risk of major or minor bleeding was low. The main objective was to assess the frequency of restenosis after six months. Intrastent and intraventricular luminal loss was significantly lower in the cilostazol group at follow-up angiography six months later. Restenosis showed a clear downward trend in the cilostazol group.

We included 809 patients enrolled in triple association studies of cilostazol with conventional antiplatelets. Key elements analyzed were restenosis, late lumen loss, and the need for target vessel revascularization. Cilostazol was associated with greater benefit across all of these parameters, as seen in the table. The risk of coronary restenosis and the need for target vessel revascularization were markedly lower in the group that used cilostazol in the triple combination.

Therapeutic measures for atherosclerosis

What medications should be taken if available? In this situation, it is required complex treatment. Currently, pharmacological and non-pharmacological methods of treatment of this pathology are used. Today, drugs are used that reduce blood lipids. They are called hypolipidemic. This is a large group of medicines, represented by the following groups:

Principles of therapy for atherosclerotic disease

For this purpose, several surgical methods with an excellent success rate. Fortunately, in last years, especially for more proximal arteries, angioplasty and stenting techniques have been developed significantly and results very similar to those obtained with classical surgery have been reported. The baseline characteristics of the population assessed did not differ between subgroups, and the result was the same for both conventional and drug-eluting stents.

The figure shows the actuarial curve of vessel permeability over three years. There were no acute, subacute or chronic thrombotic events or excessive bleeding in this analysis. The main goal was to assess the need for a new angioplasty of the target vessel. After two years of follow-up, the reduction in this result was favorable for cilostazol, and this benefit was already evident from six months.

drugs that interfere with the absorption of cholesterol;
means that reduce the production of cholesterol;
drugs that promote the destruction and excretion atherogenic lipoproteins;
additional medicines.

The development of atherosclerosis is based on metabolic disorders. In the human body, several types of lipoproteins are synthesized: very low density (VLDL), low density (LDL) and high density(HDL). The latter belong to the anti-atherogenic group, as they prevent the deposition of cholesterol and the formation of atherosclerotic plaques. Treatment involves a decrease in the concentration of atherogenic lipoproteins.

The finding that the occurrence of the disease in different areas at the same time would further increase the risk of serious complications of atherosclerosis led to increased vigilance in the detection and treatment of this disease in various large arterial areas.

Prevention of atherosclerosis

It's easier to pay attention to it. Here are some tips to prevent this disease. When atherosclerosis appeared, several procedures are possible. Because smoking is a risk factor for atherosclerosis, quitting smoking is highly recommended.

Use of statins

Today, statins are the drugs of choice in the treatment of cerebral atherosclerosis.

With an increased concentration in the bloodstream of cholesterol, drugs of the statin group are prescribed. They contain substances that can disrupt the formation of enzymes necessary for the synthesis of cholesterol. The features of these drugs are:

A balanced diet is recommended. It should reduce the intake of fats, red meat and cold cuts. Food, poultry and poultry should be privileged. Usage olive oil in condiments and for cooking reduces the risk of coronary heart disease.

Regular exercise is also recommended. Medicines can be administered in different conditions. Against hypercholesterolemia: they can limit blood levels, however, these drugs cause many side effects, and their role in occurrence is controversial when the vessel is obstructed by blood: drugs that help dissolve clots can be used. Tissue plasminogen activator is then used to dissolve the clot during a myocardial infarction: morphine can relieve pain. Aspirin helps thin the blood and can slow down the heart. . Atherosclerosis can be treated with surgery.

the ability to lower cholesterol in familial hypercholesterolemia;
the ability to inhibit the enzyme HMG-CoA reductase;
the ability to reduce the amount of cholesterol by 30-50%;
increase in HDL concentration;
reduced risk of stroke;
lack of carcinogenic and mutagenic effect.

IN medical practice most commonly used in the treatment of atherosclerosis the following drugs this group: Simvastatin, Lovastatin, Fluvastatin, Rosuvastatin, Atorvastatin. The last 2 drugs have the strongest therapeutic effect. When choosing a particular drug, the doctor must take into account the age of the patient, the severity of the disease, the presence of concomitant pathology(diabetes). Because of high probability damage to the muscular apparatus, statins are not recommended to be combined with fibrates, nicotinic acid, some antibiotics.

Goals and possibilities of treatment

For example, during bypass surgery the surgeon removes a piece of vein from the leg or part of an artery from. arterial blood uses a different path than the obstacle. . Arteriosclerosis: change blood vessels. Arteriosclerosis is determined by the change in blood vessels, the walls of the vessels become calcified, lose elasticity, and the diameter of the vessels becomes smaller and smaller, and therefore the blood cannot circulate normally.

Indeed, certain risk factors may contribute to the formation of plaques in the vascular walls. SmokingGeneric disposition to arteriosclerosisGenetic sexType 1 and 2 diabetes styleTransient hypertensionHigh blood BolzerolSuperficial stressIndependence from physical activityDecreation Chlamydial bacteria: Recent studies have shown that chronic infections chlamydia can contribute to the development of atherosclerosis. Apoplexy attacksBindacheMyocardial infarctionCardiac insufficiencyDamage in the legs in men, impotenceRenal function procedures. An essential therapeutic strategy is to eliminate possible risk factors and treat diseases that cause arteriosclerosis, such as diabetes, arterial hypertension or high level cholesterol.

Possible side effects of statins include the development of myopathy, kidney damage, decreased potency, baldness, dyspepsia, and others. Contraindications to the use of statins are the period of bearing and feeding a child, childhood, liver disease. Statins should not be taken with alcohol. The risk of side effects increases with the use of more strong drugs. Statins are mandatory for use in the combination of atherosclerosis with ischemic disease and for secondary prevention of stroke.

Saturated fatty acid present in animal fat in meat and in eggs should be prohibited.

Stop tobacco.
Rational diet and low fat.
Weight loss in case of overweight.
Important physical activity and regular.

Anticoagulant drugs that reduce the risk of thrombosis.

In case of thinning of the coronary arteries

Vascular contractions can be treated by expanding the balloon, but this is not always possible. coronary angiography to determine the narrowing; Then, expansion of the artery and possibly the posture of the stent. According to gravity and the number of coronary arteries reached, bypass setting. Arteriosclerosis is general term, indicating several diseases that have a general thickening and loss of elasticity of the artery wall. The most common and important disease is atherosclerosis. Atherosclerosis affects medium and large arteries and is characterized by thickening of the vascular wall, irregular, widespread, but which is expressed in a porno lumen leading to plaques, and in more severe cases, obstruction.

Treatment of atherosclerosis with fibrates

The second most important in complex therapy atherosclerosis are fibrates. The mechanism of action of these drugs is quite different. It is based on enhancing the activity of a special enzyme (lipoprotein lipase), which promotes the breakdown of atherogenic lipoproteins (LDL and VLDL). Fibrates can be used for both treatment and prevention. Fibrates reduce the amount total cholesterol by 10-15%, and triglycerides - by 20-50%.

Atherosclerotic plaques consist of an accumulation of fat, cells, and a diffuse or localized calcium component that increases over time. Two main hypotheses have been proposed to explain the evolution of the atherosclerotic process. The first hypothesis is a chronic accumulation of fat in the arterial wall. The second hypothesis assumes initial damage vascular wall Secondly, they accumulate cells and fat. The two hypotheses are likely to be closely related.

Drugs that affect mental activity

Most of the studies related to the prevalence and development of atherosclerosis have been conducted in other countries such as the USA, Finland and the UK. Atherosclerosis is gradual process, in which fat and calcium build up inside an artery in a manner that is similar to rust in a tube. These buildups narrow the arteries, reducing blood flow. Shrinkage is called stenosis. Platelets, small components of blood, can stick to an arterial wall or plate, forming a lump of blood called a thrombus.

These medicines are recommended to be combined with nicotinic acid. The latter is a vitamin. IN high doses it reduces the concentration of cholesterol and normalizes the content of lipoproteins. Fibric acid derivatives include the following medicines: Gemfibrozil, Clofibrate, Fenofibrate and their analogues. These drugs are most often prescribed in tablets or capsules. They are rapidly absorbed and have high bioavailability.

Part of the clot may break off and travel to a smaller vessel, stopping there and blocking all blood flow beyond that point. This sudden and often dramatic occurrence is called an embolism. The study of non-invasive ultrasound of the arterial wall is currently a recognized method for detecting early atherosclerotic anomalies. The method consists of high-resolution ultrasound of the artery wall.

The images obtained from the examined 4 arteries are processed and classified according to the morphology of the walls. Anticoagulant drugs prevent the formation of blood clots and prevent the spread of already formed blood clots. Vasodilators reduce peripheral resistance by increasing flow. Thrombolytic drugs dissolve the clots formed inside the vessel. They are used in certain cases and only in stationary conditions. In the prevention of risk factors, the most commonly used drugs are hypolytic agents, which reduce "fat" in the blood and antihypertensive agents.

Bile acid sequestrants

Sequestrants are used to treat cerebral atherosclerosis. bile acids. Until recently, they were one of the main drugs for the fight against atherosclerosis, but in recent years they have been replaced by drugs from the statin group. The mechanism of action of these drugs is based on the binding of bile acids and cholesterol. Cholesterol is required for the formation of bile acids. In the process of binding acids, there is a shortage of them in the body. The liver responds by producing more bile acids, which requires cholesterol. Thus, there is an increase in the utilization of cholesterol by the liver and a decrease in its content in the bloodstream.

However, it is important to note that before taking medication, you need to take some good rules Everyday life: no smoking, exercise physical activity, observe balanced diet. The frequency of changes in the coronary arteries, even silence, and the possible frequency of cardiovascular events in the medium term increases progressively.

As already mentioned, most studies on the prevalence and development of atherosclerosis have been conducted in other countries. We intend to follow the population for at least 10 years. Thus, you can select a group of people to consider "at risk", a group that will have to evaluate the opportunity to "do something" to block or slow down the evolution of the disease.

The most commonly used drugs are: Cholestyramine, Colestipol, Kolesevelam. In our country, these drugs are not used. Cholestyramine is indicated for the treatment of hypercholesterolemia. It reduces the risk that occurs in patients with atherosclerosis of cerebral vessels. TO side effects the drug includes a violation of the stool by the type of constipation, dyspepsia, abdominal pain, rash, increased sexual desire, development of stomach ulcers and duodenum, some others. It can reduce the absorption of some statins (Pravastatin).

Other medicines

Other medicines are also used to treat atherosclerosis. These include drugs that improve the nutrition of the vascular endothelium, synthetic derivatives of prostacyclin (Misoprostol). At severe course atherosclerosis and the presence of depression, antidepressants are indicated. Along with a diet is prescribed (restriction in the diet of fats, the use of foods rich in nicotinic acid).

The detection of atherosclerotic plaques in the arteries of the brain requires timely and complex therapy in order to prevent serious complications as a stroke or intracranial hemorrhage. Treatment of atherosclerosis of cerebral vessels is carried out by a neurologist after consultation vascular surgeon: it is important to know for sure that there is no risk of arterial thromboembolism.

Drugs and medicines prescribed by a doctor must be taken correctly, strictly observing the dosage and frequency of administration. Required condition effective therapy– changing the diet in accordance with the principles of diet therapy cerebral atherosclerosis, maintaining muscle tone with the implementation of physical exercises recommended by a specialist, long-term drug treatment in the form of a course scheme that cannot be arbitrarily terminated.

It is better to follow the advice of a doctor and constantly take medications and medicines than create the conditions for a stroke and get life-threatening complications.

Principles of therapy for atherosclerotic disease

After examination and detection of cerebral atherosclerosis, the doctor will choose the tactics of therapeutic measures, which will be based on the following criteria:

age and sex of the sick person;
the degree of damage by atherosclerosis of cerebral vessels;
suspected causes and risk factors Negative influence on cerebral status;
detection chronic diseases and complications associated with atherosclerotic disease;
the need to restore impaired cerebral blood flow;
repeated prevention.

Treatment of cerebral atherosclerosis with the selection of a drug is always individual: for each person, the doctor will prescribe a specific treatment regimen and specific drugs, taking into account all the factors affecting vascular disease.

Drug Therapy Options

All drugs and tablets used for atherosclerosis of cerebral vessels, depending on the action, are divided into groups. The doctor will treat using the following types of medication:

the main therapy, implying the impact on all possible factors risk and preventing blockage of cerebral vessels;
symptomatic therapy aimed at getting rid of pathological symptoms;
restorative treatment that helps improve cerebral blood flow.

It is necessary to take drugs and medicines exactly as indicated by the doctor in the appointments. You can not replace the medicines prescribed by the doctor with similar ones. medications. Or arbitrarily reduce the dosage of drugs.

Basic therapy

Considering the importance high performance cholesterol in atherosclerosis of cerebral vessels, it is necessary to take drugs to reduce the level of this biologically active substance. Often only long-term use single anticholesterol agent medicinal product can significantly reduce the risk of complications of cerebral atherosclerosis.

Symptomatic therapy

All medical measures in atherosclerotic disease are aimed at improving blood circulation in the vital important organs. For cerebral atherosclerosis, it is very important to follow these recommendations:

maintain a stable level blood pressure;
improve blood flow through the brachiocephalic and main vessels;
ensure optimal blood circulation in the brain area;
reduce the severity inflammatory response associated with the damaging effect on the walls of blood vessels of atherosclerotic plaques.

Drugs for antihypertensive therapy should be taken continuously for long courses with constant monitoring of blood pressure. Special vascular agents having double action- improve blood flow in small vessels and affect lipid metabolism. Against the background of an inflammatory reaction, it is sometimes necessary to use anti-inflammatory drugs.

Rehabilitation treatment

Any change in the blood flow of the cerebral vessels leaves traces in the form of ischemic disorders. The doctor at the stage of rehabilitation will prescribe treatment with the help of physiotherapy exercises, physiotherapy, massage and swimming in the pool. It will be necessary to drink pills to restore blood circulation in the region of the vessels of the brain. The main thing at this stage is to prevent the return of symptoms and remember that cerebral atherosclerosis can cause a stroke. Prevention of this complication will be the basis for preventing an acute deadly situation.

Cerebral atherosclerosis is better to prevent than to treat. Prevention of pathology includes the following principles:

proper nutrition with observance of a hypocholesterol diet;
moderate and regular exercise, walking or swimming;
giving up bad habits (smoking, drinking alcohol);
timely detection of predisposition to atherosclerotic disease;
treatment for minimal symptoms diseases, when the effectiveness of therapy is the highest.

Diet treatment

From food and eating behavior a person suffering from atherosclerosis of cerebral vessels depends a lot.

It will be possible to take a significantly smaller amount of drugs and a lower dose of the drug if animal fats are abandoned ( butter, salo). And increase the amount of vegetables, fruits and seafood in the diet.

Animal fat should be replaced with vegetable fat, the diet should be enriched with vitamins and microelements, and body weight should be constantly monitored. The diet is good for this - you do not need to take additional medicines if you start to regulate with the help of food metabolic processes in organism.

Lifestyle change

The most important risk factor is smoking. From this bad habit it is necessary to refuse immediately, without postponing for tomorrow and without gradually reducing the number of cigarettes smoked. It is necessary to completely exclude strong alcoholic drinks, although dry red wine can be drunk in small quantities.

The following preventive measures will be mandatory:

regular muscle activity corresponding to the age and severity of vascular pathology;
treatment and observation by an endocrinologist for obesity and diabetes with ongoing course treatment;
control over the regularity of the stool to speed up the excretion of cholesterol that enters the body;
required night sleep with the refusal of round-the-clock work;
reduction in the number of acute and chronic stress factors.

Of great importance secondary prevention, which implies the implementation of all the doctor's recommendations to prevent repeated episodes of cerebral circulatory disorders. In fact, if at least once in a lifetime there was an attack ischemic stroke, a person should be constantly observed by a neurologist and regularly carry out drug treatment.

Atherosclerotic disease is very dangerous state for vessels throughout the body. Worst if atherosclerotic plaque enters the vasculature of the brain, causing a stroke or cerebral hemorrhage. Treatment of the disease involves the constant intake of the main medication and symptomatic therapy. It is important to follow a diet and load muscles exercise. If everything is done correctly, following the doctor's recommendations, then the risk of complications of cerebral atherosclerosis will be minimal.