In Argentina, only one in three heart patients meets the goals of cholesterol control founded by the Argentine Society of Cardiology (SAC). The data are even more worrying for patients with very high cardiovascular risk, as the level of monitoring in this group drops to 16%. The high cholesterol – oh hypercholesterolemia– is one of the so-called silent diseases. It does not cause symptoms, pain or warning signs.
Cholesterol is one greasy substance It is present in all tissues of the human body and is necessary for the normal functioning of the organism. It serves as raw material for cell membranes (walls) and for the synthesis (manufacture) of hormones such as estrogen and androgens.
Then, cholesterol is not an enemybut in excess it generates serious health consequences by increasing the probability of cardiovascular disease. There are others lipid substances (fats) in the blood in addition to cholesterol. Among them are the triglycerideswhose height also increases the risk of heart conditions.
The cardiologists at Mayo Clinicin the US, describes the differences between these two types of lipids circulating in the blood:
– Loose triglycerides store unused calories and provides energy to the body
– The cholesterol is used to build cells and certain hormones
To reach the places in the body where it is needed, cholesterol is transported through the blood attached to proteins called proteins lipoproteins. Some lipoproteins are responsible for transporting excess cholesterol from the organs to the liver where it is recycled.
These lipoproteins that remove cholesterol are called HDL (English acronym for high-density lipoproteins), it is commonly known as good cholesterol. Other lipoproteins transport cholesterol from the liver to the rest of the organs. These are called LDL (English acronym for low density lipoproteins).
According to statistics from the 4th National Survey of Risk Factors, 39.5% of adults over the age of 18 in Argentina have LDL cholesterol levels above what is recommended.
The Argentine Cardiology Foundation explains that when there is a lot of cholesterol to transport to the organs (either because a lot of LDL is generated in the liver or a lot of food rich in fat is eaten) the cells of our body absorb what they need and the rest continues to circulate in the blood as cholesterol LDL, which is deposited on the walls of the arteries and damages them causing blockages (a process called atherosclerosis). For this reason LDL cholesterol should be low.
Loose Centers for Disease Control and Prevention (CDC, for its acronym in English) of the USA warns that lifestyle, some health conditions and family history can increase the risk of high cholesterol and triglycerides. The recommended levels are:
– Total cholesterol: about 150 mg/dL
– LDL cholesterol: about 100 mg/dL. LDL is sometimes called “bad” cholesterol because it can build up and clog your arteries, eventually leading to heart disease or stroke.
– HDL cholesterol: Ideally, it should be greater than or equal to 40 mg/dL in men and 50 mg/dL in women.. HDL is sometimes called “good” cholesterol because it can help clear your arteries of cholesterol buildup.
– Triglycerides: a level below 150 mg/dL is recommended.
“The best and most effective way to control cholesterol is through a three-pronged treatment: diet, exercise and in some cases medication. It is important to keep in mind that high cholesterol is not cured, it is managed. Once the desired values are reached, treatment is usually maintained for life”, states the Argentine Cardiology Foundation (FCA).
For its part, the CDC recommends four essential steps to lower cholesterol and triglyceride levels:
– Choose healthy food. Avoid foods high in saturated or trans fats, sugar and sodium (salt). Choose foods rich in fiber, such as fresh fruits and vegetables, and unsaturated fats, such as avocados or nuts.
– Stay physically active. Get at least 2 hours and 30 minutes of moderate exercise each week, such as cycling or brisk walking. This equates to half an hour of physical activity five days a week.
– No Smoking. Cigarette smoke damages blood vessels and significantly increases the risk of heart disease and stroke. If you don’t smoke, don’t start. If you smoke, get help to quit.
– Take medication if recommended by the doctor. A healthy diet and physical activity can help many people achieve healthy cholesterol levels, but in some cases the use of drugs is necessary to control cholesterol and triglycerides.
“In those patients who have already had cardiovascular events, who are at greater risk of presenting a new event throughout their lives, the goals are levels below 70 mg/dl. In many cases, measures for healthy eating habits and regular physical activity can activity may be sufficient in patients with low or moderate risk, but in patients with a higher risk, lipid-lowering medications are generally required, which in many cases require a combination of different treatments to achieve the goals indicated by the doctor Alberto Lorenzatti, former president of the Argentine Federation of Cardiology (MP 14541) to Infobae.
Although good and bad cholesterol are commonly used terms, many experts have recently begun to debate this definition. consulted by Infobaethe doctor Paul Corralspecialist in internal medicine, lipidologist and president of the Argentine Society of Lipids (SAL) explained that “the division between good and bad cholesterol is wrong. It has been used for many years, but cholesterol is neither good nor bad. This is an old misconception that science and scientific evidence has proven in recent years.”
To have HDL alt (the good cholesterol) does not mean you are protected from heart disease. “It is not a cardiovascular protective factor. Doctors should stop chasing the HDL cholesterol target. It is not good to have it too high or too low”, the expert concluded, noting: “Today science has no way of knowing and measuring exactly how the HDL lipoprotein works, as it is very complex is and has multiple functions that medicine does not yet unravel. Therefore, it is a mistake to follow old prescriptions.
Corral’s statement is linked to a published scientific study last year by the magazine ‘Metabolism Clinical and Experimentalthe, which determines that Not all good cholesterol is healthy, and the presence of large particles may be associated with an increased risk of heart attack. “There is a positive causal relationship between the size of the HDL cholesterol particles and the risk of heart attack, so we need to increase the levels of good cholesterol in the blood, but always in small particles,” said Roberto Elosua, a researcher . at the IMIM and the Universitat de Vic-Universitat Central de Catalunya (UVic-UCC) and one of the authors of the Spanish study.