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FAST
FACTS: CHOLESTEROL & WOMEN'S HEALTH
High blood
cholesterol is a major women's health issue. Over 50 million
American women have borderline-high to high cholesterol levels
that may put them at greater risk for heart disease—the
number one killer of women—and stroke. That's about half
of all women in the United States today.1
It's important
to have your cholesterol checked, to talk to your health care professional about
your risk factors for heart disease and stroke and to understand
what your cholesterol test results mean. Then, if you have
high cholesterol, you'll be ready to work with your health
care professional to develop a cholesterol-lowering plan that
is right for you.
It's also
important to understand that there are two sources
of cholesterol. Cholesterol does come from the food you eat,
but the majority of cholesterol is produced naturally in the
body based on family history.
Types
of Blood Cholesterol
There
are two main types of cholesterol:
- LDL cholesterol. Often called "bad" cholesterol,
too much LDL can lead to cholesterol buildup and blockage
in the arteries. LDL carries most of the cholesterol in
the blood.
- HDL cholesterol. Often called "good"
cholesterol, medical experts believe HDL works as a kind of garbage truck, transporting
LDL cholesterol from other parts of the body to the liver
for disposal.
Understanding
Cholesterol
Cholesterol
is a waxy, fat-like substance that the body needs (and produces
naturally) to make hormones, vitamin D and the bile acids
that aid in the digestion of fat. It is found in all of the
cells and membranes throughout the body. Your body needs a
certain amount of cholesterol to function. It's when LDL cholesterol
levels are too high and/or HDL cholesterol levels are too low
that you increase your risk for heart disease.
Because
the majority of cholesterol is produced naturally in the body,
your cholesterol levels are greatly influenced by your family
history. Many people are genetically predisposed to make more
cholesterol than they need.
Your diet
is another source that adds cholesterol to your body. The
typical American diet is full of cholesterol-rich foods. These
include whole dairy products, eggs, animal fats and red meat.
Over the
years, excess cholesterol and fat are deposited in the inner
walls of the arteries that supply blood to your heart. Eventually,
these deposits can make your arteries narrower and less flexible,
a condition known as atherosclerosis. Left unchecked, this
build up can lead to heart attack, stroke and death.
Getting
Your Cholesterol Measured
All women should have their blood cholesterol checked beginning at age 20 and then once every five years or more often if you have a family history of high cholesterol or other risk factors. If your blood cholesterol test results are in the moderate or high-risk range, a lipoprotein profile will be needed for appropriate management based on LDL.
Schedule
routine cholesterol screenings that measure your total cholesterol
profile and LDL levels. This is a blood test taken after you've
haven't eaten for at least 12 hours. It measures total
cholesterol, LDL, HDL and triglyceride levels.
If your
LDL cholesterol level is high, it's time to act! Talk to your
health care professional about creating a cholesterol-lowering plan tailored
for your risk factors and your family history.
Know
These Cholesterol Facts
- Blood cholesterol is measured in milligrams per deciliter
(mg/dL; a deciliter is one-tenth of a liter).
- You may reduce your risk of high cholesterol by limiting
how much of these foods you eat and by using low- and non-fat
dairy products instead of whole-milk products.
- You may have high cholesterol because of your family
health history3 even if you have a healthy weight,
get plenty of exercise and eat a heart-healthy diet.
- For most women, cholesterol levels stay in the healthy
or "desirable" range until middle age.
- At about age 45, more women than men have total blood
cholesterol of 200 mg/dL or higher, significantly increasing
their risk for heart disease.4
As menopause approaches for women, LDL (bad) cholesterol
tends to rise and HDL (good) cholesterol tends to fall.
Know
Your Numbers
The general
blood cholesterol guidelines shown below are meant for healthy
people who have few or no risk factors for heart disease.
If you have a history of heart attack, or diabetes, any
LDL level equal to or greater than 100 mg/dL is considered
too high. Talk to your health care professional to set your
cholesterol goal number.
| LDL
Level |
|
What
it Means |
|
| Less
than 100 mg/dL |
|
Optimal |
| 100-129
mg/dL |
|
Near
optimal/above optimal |
| 130-159
mg/dL |
|
Borderline
high |
| 160-189
mg/dL |
|
High |
| 190
mg/dL and above |
|
Very
high |
Your LDL
(bad) cholesterol levels are just one part of the equation.
You also need to know your HDL (good) cholesterol level. Here,
you want your HDL levels to be high; the higher the better
for your heart.
| HDL
Level |
|
What
it Means |
|
| Less than 50 mg/dL |
|
Higher
risk |
| 50-60 mg/dL |
|
Average |
| 60
mg/dL and above |
|
Protective
|
The average HDL cholesterol level for women range from 50 to 60 mg/dL. Both the American Heart Association and National Cholesterol Education Program (NCEP) recommend an HDL cholesterol level greater than 50 mg/dL for women.
Treatment
Diet,
increased physical activity and weight control are generally
recommended first steps to lowering LDL cholesterol. However,
updated NCEP guidelines have called for more intense treatment
of elevated cholesterol levels in many people with other risks
for heart disease. Generally, the more risk factors you have,
the lower your LDL level should be.
For some
women, simply cutting back on high cholesterol foods and increasing
physical activity will lower both total and LDL cholesterol.
However, many people who eat right and exercise have not been
able to reach the cholesterol goals set by their health care professional.
If lifestyle
modifications, like diet and exercise, don't work to get you
to your cholesterol goal, your health care professional might recommend a cholesterol-lowering
medication. However, in coordination with your health care professional, regular
exercise, eating a diet low in saturated fat and weight control,
will continue to be part of your overall cholesterol-management
plan.
Questions
to Ask Your Health Care Professional
- What
is my overall risk for heart disease? Can we review my risk
factors?
- What
are the two sources of cholesterol?
- Is
high cholesterol a condition that can be inherited? Can
we talk about my family health history?
- Why
do I keep hearing about "good" and "bad" cholesterol? What
are they?
- What
are triglycerides? What do they have to do with cholesterol?
- What
type of test best measures my cholesterol levels?
- Will
you explain the results of my cholesterol test?
- If
I have high LDL cholesterol, what lifestyle and dietary
changes can I make to lower it?
- What
types of food should I avoid or add to my diet? What types
and how much physical activity and exercise do you recommend?
- When
and how often should I have my cholesterol level checked
from now on?
- Based
on my cholesterol and other risk factors, is there a cholesterol
lowering plan that you would recommend specifically for
me?
- Am
I a good candidate for medication? What are the risks and
benefits of medication?
- If
I have high blood cholesterol, are my children at risk for
developing high blood cholesterol?
Resources
American
Heart Association
7272 Greenville Avenue
Dallas, TX 75231
1-800-242-8721
www.americanheart.org
Provides heart disease prevention, treatment and management
information.
American
Diabetes Association
ATTN: National Call Center
1701 North Beauregard Street
Alexandria, VA 22311
1-800-342-2383 (English and Spanish)
AskADA@diabetes.org
www.diabetes.org
Offers diabetes-related information in a variety of formats.
NHLBI
Health Information Center
PO Box 30105
Bethesda, MD 20824-0105
301-592-8573
www.nhlbi.nih.gov
Offers information on diseases of the heart, blood vessels,
lungs and blood, and sleep disorders.
WomenHeart
The National Coalition for Women with Heart Disease
818 18th Street, NW, Suite 930
Washington, DC 20006
202-728-7199
www.womenheart.org
Provides women-specific heart disease information.
Supported
by a grant from Merck-Schering/Plough Pharmaceuticals
1Heart
Disease and Stroke Statistics—2004 Update. American Heart
Association.
2Expert Panel on Detection, Evaluation, and Treatment
of High Blood Cholesterol in Adults. Executive Summary of
The Third Report of The National Cholesterol Education Program
(NCEP) Expert Panel on Detection, Evaluation, And Treatment
of High Blood Cholesterol In Adults (Adult Treatment Panel
III).
JAMA. 2001 May 16;285(19):2486-97. No abstract available.
3Austin MA, Hutter CM, Zimmern RL, Humphries SE.
Familial hypercholesterolemia and coronary heart disease:
a HuGE association review. Am J Epidemiol. 2004 Sep 1;160(5):421-9.
Review.
4High Blood Cholesterol and Other Lipids—Statistics.
American Heart Association.
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