The presence, or the need to verify, cardiovascular risk factors and the possible appearance of symptoms should be evaluated
I am 49 years old and high cholesterol: luckily I also have HDL, or good cholesterol, quite high. I don’t smoke or drink, I follow a healthy diet. I do not take statins hoping that, by resuming sport (running 40/50 minutes, 4/5 times a week), the problem can be contained. I fear that the drugs are hepatotoxic and I do not resign myself to the idea of getting old. In my situation, how often should I have a heart check?
He answers Pietro PalermoHead of the Rehabilitation Cardiology Unit, Monzino Cardiology Center, Milan (GO TO THE FORUM)
First of all, a clarification on the cholesterol value which, as he has well emphasized, must be kept under control as one of the main cardiovascular risk factors. International guidelines specify that LDL cholesterol values (low density lipoprotein) that the so-called bad cholesterol must be below certain target values established based on the patient’s risk factors. There are specific tables (score), a 10-year risk assessment system for fatal cardiovascular events which takes into account the value of systolic blood pressure, the value of total cholesterol and smoking habits (separate tables for men and women). For subjects with a low cardiovascular risk it is recommended to have LDL cholesterol less than 116 mg / dl.
The subjects who, on the other hand, have an anamnesis an already documented cardiovascular disease, patients with familial hypercholesterolemia, diabetics and those with multiple risk factors, along with those with chronic renal failure, are considered to be at high or very high risk. The recommended LDL cholesterol value in these patients respectively less than 70 mg / dl (high risk) and less than 55 mg / dl (very high risk). For those who have had a recurrence of cardiovascular disease in the past two years the value drops to meno at 40 mg/dl. The goal for each subject to pursue with recommendations on lifestyle, diet, physical activity and – if necessary – with the prescription of drugs. Statins are one of the options, but there are several drug alternatives today.
She stressed the possibility of a toxic effect of statins on the liver. It is more appropriate to talk about side effects or non-tolerance of the drug, which can also cause pain in the muscles. It does not happen to everyone but only to a minority of patients and if so the therapeutic strategy is changed. The benefit of reducing LDL cholesterol far greater than the risk of having some intolerances. She also says she has resumed physical activity after a period of inactivity. Keep in mind that practicing movement on a regular basis leads to having a positive effect on blood pressure values and a significant reduction in heart rate for the same workload performed. Finally, not to be underestimated, a positive effect on the psychesince well-being is generated.
Regular training also leads to having short heart rate recovery times after an exercise. The only precaution: the resumption of training, after a period of inactivity, must be done gradually and constantly. Finally, how often should you have a check-up by the cardiologist? It depends on the presence and need to control cardiovascular risk factors and on the possible appearance of symptoms to be investigated. For a 50-year-old who, like you, is particularly attentive to lifestyle (and in the case of a normal echocardiogram), sufficient check the lipid picturewith the collaboration of the family doctor, e see the cardiologist once a year or every two years.
October 29, 2022 (change October 29, 2022 | 09:28)
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