Jorge Tartaglione, cardiologist, on cholesterol: “To avoid risks, the most important thing of all is to have a healthy diet, weight control, and sleep well”

Cardiologist Jorge Tartaglione highlights a paradigm shift in cardiovascular medicine, moving from symptom-based intervention to proactive risk assessment. "Before, I would tell you, you have to have cholesterol below 200; today, I have to see, I have to assess your risk, I calculate your risk with my phone and see what I do. Before, it was waiting for a symptom; today, it's before," the specialist explained.

Lifestyle is central to managing cholesterol and preventing heart disease. Tartaglione advocates for a Mediterranean diet, emphasizing fresh, natural foods. "Eat what rots, eat what comes from the earth, eat what the sun gives; a Mediterranean diet." While statins are important, he stresses they must be prescribed by a doctor after a thorough evaluation. For patients experiencing leg pain, alternative treatments like bempedoic acid and newer medications may be considered.

"To avoid risks, the most important thing of all is to have a healthy diet, weight control, and sleep well," Tartaglione stated. He used an analogy of a highway to explain cholesterol's function: good cholesterol (HDL) acts like a truck collecting excess cholesterol from artery walls and taking it to the liver, while bad cholesterol (LDL) and lipoprotein A (LPA) can deposit on the walls, narrowing the arteries.

Tartaglione also stressed the importance of measuring lipoprotein A (LPA), especially for individuals with a family history of heart disease. Genetic predisposition to high LPA necessitates more aggressive LDL cholesterol reduction. Target LDL levels vary based on risk: below 100 for low to intermediate risk, below 70 for high risk, and below 55 for those with a history of heart attack or cardiac events.