High bad cholesterol is one of the leading causes of death. If not detected in time, it can cause heart attack and stroke.
The leading cause of atherosclerotic cardiovascular disease, which includes heart attack and stroke, is a high level of LDL (bad) cholesterol. Patients who are exposed to elevated values of these fats for a long time have a higher risk of developing atherosclerotic cardiovascular disease. However, it is encouraging that 80 percent of early cardiovascular conditions can be prevented, especially by better control of LDL cholesterol, which is the risk factor that can be changed most easily.
A dangerous condition without symptoms
Patients with elevated LDL cholesterol usually feel nothing and have no symptoms. In many patients, elevated cholesterol is only discovered when they experience a myocardial infarction. This is why everyone should see their doctor and get their LDL cholesterol levels checked. Men should have their first screening test for LDL cholesterol at the age of 35, and women at the age of 45, or even earlier if there are other associated diseases, if there is a family history of people who had an early heart attack or stroke. After the screening, it is very important to consult with a doctor who, in relation to the LDL cholesterol values and other parameters and risk factors, such as previous cardiovascular events in the family, will determine the level of cardiovascular risk and refer to further treatment.
“We are generally born with very low LDL cholesterol values. The problem is caused by diet, behavior, physical inactivity, obesity. However, a certain number of patients, which is not small, may also have a certain genetic error that leads to elevated cholesterol. This disease is called familial hypercholesterolemia and is not rare at all. These are people who are exposed to very high cholesterol values and if they do not control it, they often experience myocardial infarction at an earlier age. If younger people get a heart attack, familial hypercholesterolemia should always be suspected. All the studies that have been done so far clearly show that the longer the exposure to high cholesterol concentrations, the risk of atherosclerosis increases significantly.
In the treatment of elevated cholesterol levels, statins are used, because they interrupt the synthesis of cholesterol and thus reduce it. On the other hand, it has been shown after so many decades of statin use, that even if something sticks to the blood vessels, causing atherosclerosis, statins can significantly stabilize those deposits so that they are not wearable. If satisfactory effects are not achieved with statins, there are additional drugs. Fortunately, in the last few years in lipidology, the situation is as if we have stepped into the future. There has been the development of completely new drugs that have a fascinating effect. The advantage of these drugs is that some of them are given once or twice a month in the form of an injection, like insulin. In addition to being effective, with extremely few side effects, the newest generation of medications is given even once every six months and maintains the level of bad LDL cholesterol within the permissible values,” explains Prof. Dr. Katarina Lalić, endocrinologist from the University Clinical Center of Serbia.
Heart attack and stroke
The clinical manifestations of the atherosclerotic process are numerous and primarily depend on the degree and speed of narrowing. Symptoms depend on which blood vessel is blocked. When atherosclerosis develops in the arteries that supply the brain (carotid arteries), a stroke can occur, and if it affects the arteries that supply the heart (coronary arteries), a heart attack or heart attack can occur..
“Cholesterol from the blood passes into the wall of the blood vessel and is deposited in it. Then the cellular response is activated, our cells are attracted to those cholesterol crystals, which represent foreign tissues in the wall of blood vessels. In this way, the development of an atherosclerotic plaque occurs. Basically, it is the accumulation of fat with the reaction of our body. Someone who is completely healthy and someone who has had a myocardial infarction and had a stent implanted or had surgery and bypass surgery do not have the same reference values when it comes to cholesterol levels. Reference values in laboratory analyzes are valid only for a healthy population. For people who have had a cardiac event, those values are much lower. If a completely healthy person has bad cholesterol of 2.5 mmol/l, that’s fine. However, the same amount of bad cholesterol is not good for a person who has already had a heart attack. According to European recommendations, bad cholesterol must be below 1.4 mmol/l in such patients. However, there is a problem when we talk to patients and tell them that their cholesterol is not good, and they see from laboratory analyzes that these values are within normal limits. We are talking with our colleagues who deal with laboratory medicine, to include a scale of reference values for people who have previously had a cardiac event,” Prof. Dr. Petar Otašević, manager of the Cardiology Clinic at the Institute for Cardiovascular Diseases in Dedinje.
In order to improve public health, particularly in the segment of cardiovascular diseases, it is necessary to enable a good strategy for the control and prevention of chronic non-communicable diseases, among which CVD is the leading cause of death in the population.
“We all think ‘it won’t be me,’ but that’s wrong. A heart attack comes suddenly and does not choose gender, age, person or race. Patients, above all, should listen to their doctors/cardiologists, lead an orderly life, go for regular check-ups and take the prescribed medicines. If everyone would make that small effort for themselves and their loved ones, I believe that we could save a large number of human lives, that we could prevent a large number of heart attacks and prevent fatal outcomes,” said Ivan Toljagić, president of the “My Second Chance” Association.
(WORLD)