Bad cholesterol (LDL) is one of the main cardiovascular risk factors, hence the need to control its values over the course of life. It also applies to those who have faced a heart attack: they are a chronic patient, like a diabetic or cancer patient. Therefore, once the acute event has been overcome, it is important to follow the therapies in a timely and constant manner, otherwise the risk is that the pathology progresses. However, in the period of the Covid emergency, patients interrupted or were discontinued in their care, including with regard to hypercholesterolemia. Result? They actually increased the risk of a subsequent cardiovascular event. The confirmation comes from an analysis conducted between 2019 and 2020 by the Regional Health Agency (Ars) of Tuscany and by the University of Florence, in collaboration with Novartis, aimed at verifying the impact of the pandemic on the quality of care hypercholesterolemia in the region, taking into consideration the information on the consumption of drugs and laboratory tests extracted from the administrative flows of the Tuscan health system. This is what is reported in an article published in ‘Allies for Health’ (www.alleatiperlasalute.it), a portal dedicated to medical-scientific information created by Novartis. The survey examined residents over the age of 45 in the areas of the former ASL of Massa Carrara, Empoli, Viareggio, Prato, Arezzo, Siena and Grosseto, for which the results of the laboratory tests carried out were available and are Two cohorts were analyzed, one for the year 2019 and one for the year 2020. Objective of the study: to create a monitoring tool for the evaluation and management of the management of patients with primary hypercholesterolemia (familial and non-familial) . Comparing 2020 with 2019, there is no reduction in the overall number of people taking at least one drug, which actually increases slightly. However, there is a reduction in those who carry out therapy continuously, and also among patients with the highest risk levels (diabetics with previous Mace, Major adverse cardiovascular event) the number of those who did not receive any drug treatment is significant. “We know that high cholesterol levels are associated with an increase in cardiovascular risk – says Rossella Marcucci, professor of internal medicine at the University of Florence and director of the Atherothrombotic Diseases Department at the Careggi Hospital – but also, and above all, that the pharmacological reduction cholesterol levels are associated with a reduction in cardiovascular events, which consequently entails a reduction in terms of death events and costs for the National Health Service “. From the epidemiological study conducted on patients who “had a monitored level of LDL cholesterol – reports the specialist – it emerges that more than 50% of patients in secondary prevention, therefore at high, high or very high risk, do not have cholesterol levels. Ldl that we recommend and recommend and that the guidelines indicate to us. In other words, they are not at target. If patients are at high or very high risk, or have already had a cardiovascular event, the cholesterol level must be below 50 mg / deciliter or below 70 mg / deciliter Well, the analysis shows that more than 50% of patients are not at target, that is, they have higher bad cholesterol values than those allowed for these categories of patients. they are more at risk of heart attack, stroke and death. ” Specifically, “86% of non-diabetic patients who had or have had a cardiovascular event are not at target, just as 74% of diabetic patients with a cardiovascular event are not at target. So the picture is not very comforting” . Overall – the article reads – the results show that there is under-treatment of patients with low achievement of the targets identified by the guidelines, even in the highest cardiovascular risk classes. The number of people who receive pharmacological treatment for hypercholesterolemia is in fact lower than expected, especially among patients with diabetes and / or previous Mace. The pandemic has therefore led to a worsening of the quality of care for hypercholesterolemia, causing a significant reduction in the number of determinations of the lipid picture in the laboratories of the region. However, the number of patients who received at least one prescription for a cholesterol-lowering drug during 2020 has not decreased. The data of the study “are very important in clinical reality – comments Marcucci – and highlight a huge problem: despite the recommendations to keep cholesterol down, this message does not reach our patients. There is no adequate path to reach the goal: make people more aware of the risk. Therapies are not lacking. Indeed, we have many available: the first level standard (including statins) and second level (PCSK9 inhibitors), and new generations of drugs are on the way (for example the SiRna). All ‘weapons’ that in theory can reduce cholesterol by 80-85%, so if we do not succeed in this objective it means that we need to work on the pathways and on the doctors as well as on the patients “. The next step, the quickest, “that we plan to do in Tuscany is to propose an ad hoc path that allows us to follow patients, all at high risk and in secondary prevention, once discharged, with a first therapy. , so as to verify that actually better results are obtained. In the discharge letters many beautiful things are written – concludes the expert – but if the patients are not followed even once they return home, there is a risk that those recommendations are lost, as in fact it happens “. The complete article is available on: https://www.alleatiperlasalute.it/alla-scoperta-di/ipercolesterolemia-limpatto-del-covid-sulle-cure-studio-nella-regione-toscana.