LDL cholesterol is responsible for the mechanism that leads to blockage of the arteries. This is why it is essential to lower it as much as possible, especially for those who have already had a heart attack or stroke.
Plaques consisting mainly of cholesterol begin to form and thicken in the walls of the arteries. At first they hinder the flow of blood, in the long run they can injure giving way to thrombosis phenomena that occlude the vessel, with the consequent onset of heart attack, stroke and other serious circulatory problems, often also to damage to the lower limbs. LDL cholesterol, in addition to settling on the artery wall in what is called “stable” plaque (a bit like limestone along the pipes), can facilitate the breaking of the plaque itself. It becomes unstable, with the formation of an obstruction that blocks circulation in the vessel and causes ischemia. In practice, the plate is like a volcano. If it is well “covered” it does not erupt, but if it lets its contents go outside it can cause blockage in the circulation and therefore a heart attack or stroke.
Plaque stability is therefore a key factor in controlling arterial health for everyone and in particular for those at high or very high risk. Bringing cholesterol to the lowest possible levels becomes a fundamental goal of secondary prevention. If for healthy people the focus is mainly on lifestyles to control cardiovascular risk factors, possibly associated with medications recommended by the doctor, in those who have already had signs of atherosclerosis that have “attacked” the arteries, reduce cholesterol to a minimum it is essential to reduce future risks.
The guidelines instruct patients who have suffered a heart attack to maintain cholesterol levels within 55 milligrams per deciliter or even 40 milligrams per deciliter. It is in fact necessary to avoid that the volcano, that is the plate, erupts and gives way to a cascade of dangerous events.
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