The heart’s greatest allies (and enemies)

Risposta: These are three key factors in the progression of cardiovascular risk. All three can accelerate the processes of atherosclerosis, which cause irreversible damage to the walls of our blood vessels and to heart function, leading to the development of conditions such as heart attacks, heart failure and strokes. Heart disease remains the leading cause of death today, and these risk factors bear the main responsibility for this grim statistic. All studies conducted on this subject agree that managing these risk factors must begin as early as possible in order to achieve the maximum benefit, which consists not only of adding years to life but, above all, of enhancing the quality of life during those years. It is not just a matter of living longer, but also of living in good health; bear in mind that cardiovascular diseases, as well as being the leading cause of death, are also the leading cause of disability. For this reason, it is essential to take early action to halt their negative effects: monitoring blood pressure, keeping LDL cholesterol and blood sugar levels under control are the key steps to preventing adverse events. As regards blood pressure, the ideal would be to have systolic readings below 120 mmHg – the so-called ‘maximum’ pressure – and diastolic readings below 85 mmHg – the so-called ‘minimum’ blood pressure. Please note that blood pressure readings tend to fall in hot weather or due to fluid loss, which can be caused by vomiting, diarrhoea or profuse sweating. Conversely, blood pressure may rise in cold weather, due to a high-salt diet or emotional stress. For this reason, anyone taking antihypertensive medication should have their own blood pressure monitor and, in consultation with their GP, adjust their treatment if their readings become too high or too low. When it comes to managing blood glucose levels, the first piece of advice is always to follow a healthy diet and take regular exercise. If this proves insufficient, it will be necessary to use oral medication and/or insulin. In recent years, two very important classes of drugs have been introduced into clinical practice, as they are capable not only of lowering blood glucose levels but also of protecting the heart. GLP-1 receptor agonists, which are also widely used for weight loss, have significantly reduced cardiovascular events in both people with diabetes and those who are overweight. Gliflozins, in addition to significantly reducing cardiovascular events, have also shown a significant benefit in protecting our kidneys. Finally, LDL cholesterol – the enemy of the heart – is the subject of the largest number of clinical trials. All the data collected in these studies involving hundreds of thousands of patients point in one direction: the lower the level, the lower the risk of a cardiovascular event. Another extremely important finding is that the earlier we begin to control it, the more effective we are at preventing serious events such as myocardial infarction and stroke. The most important message is that these enemies of the heart must be managed as early as possible in order to slow down or, better still, halt the progression of atherosclerosis. When it comes to the heart, we cannot afford to wait for the condition to manifest itself – by then it would already be too late; the best course of action is to take pre-emptive action!