On January 10, a public debate on the topic of cholesterol “Cholesterol: myths and reality” was held at the People’s Bookshop in Viru Keskus. The topic was discussed by cardiologist Märt Elmet, president of the Estonian Cardiology Society (EKS), family doctor Alina Terep, Valdo Jahilo, representative of the Institute for Health Development, and Anneli Raave-Sepp, doctor of Synlab laboratory.
Cardiologist Märt Elmet said: “Cholesterol itself may not be the problem, it is a completely normal component of the body that is obtained through food and the body synthesizes it on its own. About 70% of cholesterol is produced by our liver and is genetically determined, while about 30% comes from food. Problems arise when cholesterol is too high and several cholesterol levels are out of place. It begins to damage blood vessels throughout the body. A heart attack is one of the most common, but also most fatal, consequences of this process. What makes it difficult is that there is a long interval between the complications of high cholesterol and the onset of a heart attack. A person with high cholesterol can live for decades, and the complication comes when it is too late to react. In addition to high cholesterol, it is always necessary to take into account all other risk factors for heart disease and the sum of their negative effects. For example, hypertension is also an easily detectable, but at the same time easily correctable health problem, which is still not sufficiently diagnosed and treated in Estonia.”
According to the agreed limits, a healthy person’s total cholesterol should be less than 5 mmol/l, HDL or “good” cholesterol should be more than 1.0 mmol/l and LDL or “bad” cholesterol should be less than 3 mmol/l. Annely Raave-Sepp noted that Synlab does about 350,000 cholesterol tests a year, and about 60% of them are not OK, meaning they don’t meet the limits.
Family doctor Alina Terep explained: “If a person obtains a reference range from the laboratory, within which the indicators might lie, then the family doctor sets an individual target based on the individual’s risk level. These numbers, set as a target by the family doctor or cardiologist, may differ from laboratory recommendations. If the patient already has heart or vascular disease, diabetes, kidney disease or other additional risk factors, significantly lower cholesterol reduction targets are used.” For example, the target value for LDL cholesterol, or “bad” cholesterol, for a patient who has had a heart attack is less than 1.4 mmol/l.
Roundtable participants recommended that a healthy person have their cholesterol levels checked every five years and every two to three years after age 50, as cholesterol levels increase with age.
Measuring cholesterol and, if necessary, lowering it is a simple and economical way to improve public health. Treatment of heart disease costs a lot, while prevention is an economical and highly profitable activity. During the discussion it emerged that a lot can be done with lifestyle and food awareness. For example, the principles of healthy eating and food preparation should be taught already at school, so that a person begins to make more informed choices even as an adult. The plate rule must be followed, according to which three quarters of the food could be vegetables, a quarter animal; everything can be eaten in the right quantity. Foods rich in cholesterol are of animal origin, including milk fat. Specialists have emphasized the need for exercise to control bad cholesterol levels.
According to Elmet, lowering cholesterol doesn’t start immediately with medications, but you think ahead and try other options. “The experience of using cholesterol-lowering drugs in the world is very large, many studies have thoroughly described their positive effects and possible side effects. Cholesterol-lowering drugs are widely available in Estonia and at affordable prices. Their use is hampered by unjustified fear of side effects and drug addiction,” he said.
According to the speakers, it is unfortunate that patients with high cholesterol levels usually do not change their health behavior and the problem is ignored. Since the person does not directly experience elevated cholesterol and blood pressure, the nickname “”silent killer“or the silent killer. Since the accumulation of cholesterol in the blood vessels is a long-term process, the first manifestation of the disease can be fatal. Therefore, it is important for people to be aware of their cholesterol levels and keep them under check.
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2024-01-12 13:00:00
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