Cholesterol is a fat, a fundamental substance of our organism; it is a component of all cells and it is present in the walls of all the cells that make up our body. It is also present in a share that circulates in the blood and a part of it is introduced through eating.

Dr. Maddalena Lettino, Head of Cardiology and Heart Failure at Humanitas, a studio guest at Buonasera, doctor on TV2000, spoke about high levels of bad cholesterol, the risks it entails and how to counter it.


Two types of cholesterol

“We distinguish two types of cholesterol: the so-called good cholesterol (HDL) which protects us, and bad cholesterol (LDL), which if it reaches a threshold level that is too high (according to the limits defined by the guidelines) ends up settling in the walls of the vessels and causes scale, generating the so-called atherosclerotic plaque. This structure narrows the lumen of the vessel and causes less blood to pass through, which can also cause the formation of a clot; if this phenomenon occurs in the coronary circulation we talk about heart attack; when it happens in the brain circulation we refer to it as a stroke,” explains the doctor.


Lower bad cholesterol

“The first step is to change your lifestyle, improving physical activity and maintaining your diet, so that you do not introduce excessive cholesterol with meals. Controlling cardiovascular risk factors is crucial.

However, for those with abnormal values, this is often not enough and medication is needed.

Traditional therapy involves the use of statins, which “have revolutionized the therapy for cholesterol and in these twenty years have allowed great success. There are, however, cases where cholesterol is so high that despite the maximum tolerated statin dose and the use of more powerful statins, it is not possible to achieve satisfactory results in preventing cardiovascular disease.


Monoclonal antibodies: new drugs

“The new drugs are monoclonal antibodies and are directed against certain substances that help regulate cholesterol levels in our body. As antibodies, they are no longer administered by mouth, but subcutaneously, and are therefore administered much more rarely than oral therapy, approximately once or twice a month. The mode of administration is a bit reminiscent of insulin, so we can imagine a pen within which there is a container with the fluid of the drug.

These drugs will be added to statins in the first instance and will be used as an alternative in patients who do not tolerate statin and therefore cannot undergo traditional therapy,” concluded the doctor.