High blood pressure and cholesterol: cardiovascular risk factors not to underestimate

“Blood pressure is the force with which blood is pushed against the walls of the arteries. Hypertension is diagnosed when values exceed what is considered normal consistently over time,” explains Dr. Sabbatucci.

In the adult population, the threshold values are:

• 140 mmHg systolic pressure (maximum);
• 90 mmHg diastolic pressure (minimum).

In diabetic patients or those at high cardiovascular risk, recommended values should be even lower.

What damage does high blood pressure cause to the heart?

When blood pressure is elevated, the heart has to work harder against increased resistance. In this situation, like any muscle under constant strain, it tends to thicken, leading to a condition known as cardiac hypertrophy.

“In the early stages, this adaptation allows the heart to maintain good contractile function. Over time, however, an overly thickened heart can become less elastic and more ‘fatigued,’ increasing the risk of:

• reduced cardiac efficiency;
• heart failure;
• greater susceptibility to arrhythmias,” explains the cardiologist from Villa Chiara.

Regularly monitoring blood pressure (even with a simple home device) helps protect the heart from constant overload and allows early intervention to prevent long-term damage.

Cholesterol is a fatty substance present in the blood, essential for many bodily functions. However, when in excess, it becomes harmful. There are two main types:

• LDL, the so-called “bad” cholesterol, which promotes plaque formation in the arteries;
• HDL, the “good” cholesterol, which helps remove excess cholesterol.

The parameter most closely linked to cardiovascular risk is LDL levels.

LDL target values vary depending on the patient’s risk:

• around <115 mg/dL in healthy individuals without other risk factors;
• <100 mg/dL in diabetic patients;
• <55 mg/dL in patients who have already experienced a cardiovascular event (secondary prevention).

“The higher the overall cardiovascular risk, the stricter cholesterol control needs to be,” adds the specialist.

What effects does high cholesterol have on the heart?

“When excess LDL accumulates in the walls of arteries, including the coronary arteries (which supply the heart), plaques called atherosclerotic plaques can form. This process can lead to:

• narrowing of the arteries;
• reduced blood flow to the heart;
• increased risk of heart attack.”

When hypertension and high cholesterol coexist, cardiovascular risk increases significantly.

“On one hand, high blood pressure damages the arterial walls, making them more vulnerable; on the other, excess LDL promotes plaque formation on these already stressed walls. The result may be:

• progressive narrowing of the coronary arteries;
• higher risk of heart attack;
• worsening heart function over time,” explains Dr. Sabbatucci.

For this reason, assessment is never based on a single value, but on overall cardiovascular risk, including diabetes, family history, smoking, obesity, and lifestyle.

Reducing cardiovascular risk is based on two pillars: a healthy lifestyle and, when necessary, medical therapy prescribed by a doctor.

Balanced diet

A proper diet helps to:

• reduce LDL cholesterol;
• control blood pressure;
• prevent overweight and diabetes.

“It is important to:

• limit saturated fats, sugars, and salt;
• prioritize fruits, vegetables, legumes, fish, and whole grains,” adds the doctor.

Regular physical activity

Consistent aerobic exercise (20–30 minutes, 2–3 times per week) helps to:

• lower blood pressure;
• improve lipid profile;
• control body weight.

Drug therapy

When lifestyle changes are not enough, or when multiple risk factors are present, medication may be necessary:

• for hypertension, different classes of drugs help maintain safe blood pressure levels;
• for cholesterol, treatments aim to reduce LDL based on individual risk.

Since high blood pressure and high cholesterol can be asymptomatic, regular monitoring is essential, including:

• blood pressure measurement;
• blood tests for lipid profile;
• cardiology evaluation in patients with risk factors.

“Prevention means acting before a cardiovascular event occurs. With proper monitoring and a healthy lifestyle, it is possible to significantly reduce risk and protect the heart over time,” concludes Dr. Sabbatucci.