Cholesterol is a silent killer, 40% underestimate it

AGI – Silent, invisible and underestimated. Cholesterol is today among the main culprits of over 18.6 million victims of cardiovascular diseases in the world, which in Italy represent 34.8% of total deaths. But these diseases are still underestimated, with less than one in two Italians able to distinguish ‘good’ from ‘bad’ cholesterol. The alarming picture is taken by the SWG survey for Sanofi presented today in Milan on the occasion of the meeting ‘Prevention that is at heart. Cardiovascular disease and cholesterol in high-risk patients: act first, intensively and effectively, to reduce mortality ‘.

Over 40% of respondents underestimate the risks associated with high cholesterol levels, while about 1 in 3 believe that the risk of mortality associated with hypercholesterolemia should only concern those with previous heart problems.

One in three deaths is related to heart disease

And again, less than 1 in 2 (43% of the sample) know that LDL cholesterol is harmful to our health. The aim of the research, conducted on a sample of over 1,200 subjects aged between 45 and 74 years, was to analyze the knowledge of cardiovascular diseases and the perception about the consequences of hypercholesterolemia, to offer food for thought and concrete stimuli a few days before the World Heart Day scheduled for 29 September. “We are in 2022, but the knowledge of cardiovascular diseases in Italy is not brilliant, indeed” comments Emanuela Folco, president of the Italian Heart Foundation (FIPC).

“In our country, over 1 in 3 deaths is attributable to cardiovascular diseases. They are the leading cause of death both for men, with 98 thousand deaths a year (31.7% of the total), and for women, with 127 thousand deaths year (37.7% of the total) “.

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According to Folco, the numbers on women’s mortality represent “a very important data, because women are often not aware of being at risk of cardiovascular disease because, for a definition that we have been carrying around for years, these diseases are male diseases. But this is true. it is not true. Women die with a difference of about 10 years compared to men, but they die from cardiovascular disease and not from breast cancer. This is what the ISS numbers tell us “.

A silent disease

But the difficulty in fighting cardiovascular diseases, continues Folco, is also in theirs “peculiarity” of being “silent diseases”, or rather that “they develop and we do not notice them, unless we do periodic exams. We are not afraid, but this is dramatic because the numbers are dramatic”. The key to fighting these ‘silent’ pathologies is therefore prevention.

But if 92% of the interviewees say they are convinced that cardiovascular problems can be avoided, this belief does not correspond to concrete actions. Only for 17% of the sample, in fact, it is advisable to periodically carry out check-ups, while only 31% underwent a cardiovascular risk assessment in the last 12 months.

However, more than others, patients with high cardiovascular risk are unable to escape regular checks and represent, according to international guidelines, the real and urgent priority in the context of preventive interventions. “The issue of prevention is of great importance for all of us, but it becomes crucial when it comes to patients with high cardiovascular risk – comments Ciro Indolfi, president of the Italian Society of Cardiology – who has been affected by a cardiovascular event, in fact, runs a high risk of suffering a new heart attack or stroke in the following years. Events that could be significantly reduced if secondary prevention strategies were increasingly implemented “.

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Indolfi then explains that “precisely in the direction of a early and rapid treatment is the lowering of Ldl cholesterol thresholds for access to the new PCSK9 anti-cholesterol drugs, recently published in the Official Gazette by AIFA. Scientific evidence shows that LDL cholesterol is the cause of cardiovascular pathologies, not a risk factor, and how its reduction represents one of the main objectives for limiting cardiovascular events such as myocardial infarction and counteracting mortality “.

The president of the Italian Society of Cardiology then adds that “the guidelines of the European Society of Cardiology suggest Ldl cholesterol levels below 55 mg / dl in secondary prevention and, in some particularly at risk patients, even lower Ldl-C levels. and lower than 40 mg / dl. These ambitious goals can now be achieved thanks to new drugs such as monoclonal antibodies, which are inhibitors of the PCSK9 protein, capable of reducing the level of so-called bad cholesterol by 60%, demonstrating a clear clinical benefit. in patients with high cardiovascular risk “.


The patient at high cardiovascular risk has undergone one or more cardiovascular events and is a chronic patient who must be treated as such. Although he is often on oral medications such as statins and ezetimibe, he continues to have high LDL cholesterol levels. For this reason the management of him today represents one of the main complexities for the National Health Systems.

“The most important thing is treat the lipid profile from a therapeutic and pharmacological point of view – explains Giuseppe Di Tano, president of the National Association of Hospital Cardiologists (ANMCO) Lombardia – the measure of the adequacy of the treatment gives us the LDL, a silent parameter from a symptomatic point of view but easily reproducible and objective, which allows the family doctor or the cardiologist to be very incisive “.

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“If statins, which are the most commonly used drugs, fail to guarantee an adequate level of LDL, another drug must be added. The research – adds Di Tano – is helping because compared to the treatment of hypercholesterolemia we now have a lot of drugs. aggressive and very effective, because they act on very fine parameters and therefore allow to reach lower levels of Ldl, in the face of lower side effects “.

Italians ignore the risks

But if the research goes on, on the perception of hypercholesterolemia there is still a lot to do. According to the research, in fact, 20% of Italians do not even know the risks deriving from high cholesterol levels, while for 42% the control of the cholesterol level depends only on the diet and physical activity, thus neglecting the therapeutic efficacy. But this chronic condition also has an impact on the patient’s life: in fact, the percentage of people with high cholesterol who claim to have changed their habits, with more regard to family life (24%), rises up to 80% and even working (11%).