The really “bad” high LDL cholesterol. Like hypertension, a silent killer that every year in Italy contributes to tens of thousands of heart attacks and strokes. Not everyone really knows this enemy and the dangers of him, what are the thresholds not to exceed, how much it is necessary to know whether or not you are at high cardiovascular risk. But there is the good news: keeping LDL cholesterol under control as possible, by changing your lifestyle or, if necessary, with medications.
It was discussed at Tempo della Salute, taking place in Milan at the Museum of Science and Technology, during a meeting entitled How bad is bad cholesterol. And because knowing it can save your life, moderated by the journalist of the Health Courier Elena Meli, with Furio Colivicchipresident of the National Association of Hospital Cardiologists (Anmco) e Ciro Indolfifull professor of Cardiology, director of the Cardiovascular Diseases Research Center at the Magna Graecia University.
The lower, the better
The special note is the “bad” cholesterol, ie LDL. Says Ciro Indolfi, full professor of Cardiology, director of the Research Center for Cardiovascular Diseases at the Magna Graecia University: The patient who has had a heart attack, then becomes more aware and attentive even to high cholesterol, the problem instead is the person who is well , because cholesterol is not associated with symptoms, so for many years a person can have very high levels of LDL cholesterol without knowing it, and this can cause a heart attack. Today we know that the event that causes the heart attack is high LDL cholesterol. And we also know that the lower, the better: the recent guidelines of European scientific societies say so.
The “magic” number
But what are the normal values? The magic number does not exist. He answers Ciro Indolfi: A normal person with no health problems must keep LDL cholesterol below 116, while a person who has had a heart attack or has diagnosed coronary or carotid stenosis, therefore a higher risk of heart attack, must keep LDL cholesterol low. below 55. Again: if a patient has two very high-risk events within two years, then the optimal threshold for “bad” cholesterol must be below 40. Until a few years ago we could not control the bad cholesterol – underlines the cardiologist -. The good news that today we have the therapeutic weapons to fight it. For many years we have been using statins, effective drugs taken by a large part of the population, which have enabled us to reduce bad cholesterol. Today we also have innovative drugs available, i.e. monoclonal antibodies, which we can prescribe at the expense of the National Health Service even to subjects who have LDL cholesterol greater than 70.
Weapons
In the second decade of this century we understood that bad cholesterol, which is the expression of the concentration of low-density lipoproteins in the blood, was not simply a risk factor but the causative element of the disease – points out Furio Colivicchi, president of the National Association of Hospital Cardiologists (Anmco) -. In 2017, scientific societies around the world expressed a clear position. We understood that the lower the bad cholesterol levels, the higher the likelihood that our patients, already suffering from a heart attack, would survive. Having understood the mechanism of development of the disease, we face it more incisively, also because the therapeutic weapons have changed. But, if bad cholesterol is asymptomatic, how can you prevent it from going undisturbed for years? Meanwhile, to measure it, a simple blood test is enough.
Beware of diabetes, high blood pressure, smoking
116 the minimum level that all people who have not had cardiovascular disease should have – he specifies Colivicchi -. But if the patient has high blood pressure, diabetes – even if controlled – smokes, the interventions must be on all these elements and also on cholesterol, which must be even lower, below 100. Obviously the intervention must be personalized. correct blood pressure if high, remove cigarettes if you smoke, exercise because it always helps to maintain a good state of health, finally we must attack cholesterol and, if necessary, continue the therapy over time, to prevent heart attack.
People over 45 should know what their cardiovascular risk is – continues the cardiologist -. Any citizen can calculate it independently by then consulting with their own doctor: on the website of the Istituto Superiore di Sanit you can find the Cardiovascular Risk Card in the “Heart project” section.
November 11, 2022 (change November 11, 2022 | 17:05)
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