The more enemies there are, the more adequate countermeasures must be prepared to deal with them. The war metaphor lends itself well to the situation of the heart of many people in Italy, where cardiovascular diseases are still the cause of 36% of deaths. In this case, the dangerous alliance for heart and arterial health has a name: hypertension. It is the particular condition in which both the pressure rises above the warning levels and the LDL cholesterol, the bad one, overflows beyond the desired threshold. Research has shown that a person is more likely to have both risk factors, especially as they age. And precisely for these people, based on the actual danger to the heart and arteries, it is necessary to study tailor-made strategies to control the situation.
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“In primary prevention, lifestyle counts a lot: you need to do physical activity (in Europe, just under one in four of adults moves as much as it should), fight a sedentary lifestyle (almost 40% of subjects between 50 and 70 years of age do not moves enough) to fight smoking and also act on economic and social conditions – he explains Leonardo De Luca, who works at the Cardiology of the San Camillo-Forlanini Hospital of Rome – the situation obviously becomes more complex if we are talking about secondary prevention, or rather of people who already suffer from cardiovascular diseases. In these cases, it is necessary to have much more stringent objectives to counteract lipitension, with permitted values of LDL cholesterol and blood pressure that require pharmacological treatments to be achieved. Think that those who have levels of these two parameters beyond the limits may present a risk of cardiovascular disease and death that can be even eleven times greater than those who have normal levels “.
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The problem, in these cases, is twofold. On the one hand, it is necessary to identify who is at risk, on the other, this is the challenge, to ensure that they regularly take the treatments indicated by the doctor. Unfortunately, the statistics show that adherence to treatment is a difficult obstacle to overcome: in those suffering from “lipitension”, in two out of three cases after only six months from an acute event, the population at risk does not follow the treatment slavishly. And, equally with regret, cardiologists reveal that a valid adherence to treatments would be enough to have a 20-25% less risk of developing a disease. “Today we know that lack of adherence can be considered a real additional risk factor for heart patients – reports De Luca – just think that even the National Chronicity Plan of the Ministry of Health indicates how it is necessary to identify solutions that allow to increase this parameter for a more effective risk control. In this sense, the recommendation goes towards the so-called “polypills”, or tablets that allow the administration of various active ingredients in a single solution, both for the sole control of hypertension and to reduce both the values of blood pressure as much as Ldl cholesterol.
Today, the European Society of Cardiology recommends this strategy from an early stage in those suffering from “lipitension”, since it allows for better outcomes both in terms of ischemic events such as heart attacks and mortality “. As if that were not enough, we are also studies that show how the simplicity of administration for hypertensive patients, “compacting” the drugs can also have a greater benefit than an increase in the dosage of the single drug. This is important information in terms of management of people at cardiovascular risk that today, thanks to the widespread problems affecting the metabolism, are more and more frequent.
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“There is another data that makes us think in a positive sense – concludes the expert – there are observations that show how the association of a statin to reduce cholesterol can positively affect the pressure levels obtainable with antihypertensive therapy and how drugs to reduce blood pressure in combination with those for dyslipidemia can give an additional advantage in terms of the control of Ldl. Add to this the greater adherence that the patient can have thanks to the fewer “appointments” with the therapies , it can be said that the polypill, when the indication is appropriate, can represent an effective weapon to control “lipitension” in subjects at cardiovascular risk “.
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