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Cardiovascular Health Q1 2023

Lower is better for a healthy heart: keeping lipids under control

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Dr Peter Penson

Reader in Cardiovascular Pharmacology, Liverpool John Moores University; Medical Scientific & Research committee, HEART UK

Heart attacks, strokes and angina are caused when fats (lipids) accumulate in the walls of our arteries. Keeping levels of harmful lipids low can prevent these deadly conditions.

Lipids, such as cholesterol are essential to life. However, almost half of UK adults have raised cholesterol which can lead to heart disease. Cholesterol is carried in a variety of lipoproteins. Low-Density Lipoproteins (sometimes called LDL-cholesterol or ‘bad cholesterol’) enter and remain in the walls of blood vessels. This causes heart attacks and strokes.

The process starts very early in life, with early stages seen in teens and twenty-somethings. To protect our health as we get older, it is essential to reduce LDL-cholesterol.

Keeping lipids low throughout life

Maintaining a healthy diet and making simple lifestyle changes can keep LDL-cholesterol levels low. Swapping saturated fats for unsaturated fats can reduce the levels of LDL-cholesterol. The HEART UK website has information and healthy recipes for you to try. Additionally, cutting down on alcohol, avoiding smoking; and regular exercise are great ways to protect the heart.

To protect our health as we get older, it
is essential to reduce LDL-cholesterol.

Safe and effective drugs

We all produce cholesterol in our liver, and this can contribute to the risk of heart disease. This is especially relevant in people with familial hypercholesterolaemia, who have a genetic tendency to accumulate LDL-cholesterol. When someone has an increased risk of heart disease, medicines can be used together with lifestyle changes to give additional benefits.

The most common treatment for raised LDL-cholesterol is a family of drugs called statins. These drugs block the production of cholesterol in the liver.

Statins often work very well. They can reduce your LDL-cholesterol by around 30%, sometimes even 50% with high doses. This reduces the risk of heart attacks and strokes. When you start taking a statin, the prescriber will take blood tests to ensure that the drug is reducing LDL-cholesterol as expected.

All medicines cause side effects, and statins are no different. If you do experience side effects with statins, it is important to talk to your prescriber to resolve the issues together — simply stopping the medicine may put you at greater risk of heart disease.

Other medicines

Sometimes, even statins are not enough to reduce the LDL-cholesterol, and there are some patients for whom statins are not suitable. In this situation, a range of additional drugs is available depending on the patient’s circumstances.

However it is achieved, the important thing is for everyone to keep LDL-cholesterol as low as possible for as long as possible to protect us from heart disease.

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