• Practical Prevention—Cholesterol Counts for Women and Seniors Too

    Woman heart disease image Most people know that middle-aged men with high cholesterol levels are prone to heart attacks. What many people don't seem to understand is that cholesterol is just as dangerous for women and people over age 65.
    In the US, coronary heart disease is the leading killer of women, as well as men. About equal numbers of both sexes contribute to the toll of over 500,000 deaths each year from heart disease. There are some differences, though. For instance, men tend to develop heart attacks earlier, while women usually don't experience them until later in life.

    Postmenopausal Changes in Cholesterol

    Women rapidly catch up with men with respect to heart disease during menopause. The female sex hormone estrogen tends to raise HDL (good cholesterol). A woman produces the most estrogen during her childbearing years. When she enters menopause, her body produces less estrogen. At this time the ample levels of HDL that seem to protect younger women take a nosedive. Other blood fats such as triglycerides and LDL (bad cholesterol) may start to skyrocket. As a result, about 75% of women over age 55 have unhealthy levels of cholesterol as compared to only 25% of younger women. These changes at least partly explain why a woman's risk of heart attack more than doubles after menopause.

    Better Care for Women and Seniors

    Research suggests that cholesterol treatment is at least as effective in preventing heart disease in women and seniors as it is in younger men. It is just as important for women and seniors to monitor their cholesterol levels and make the lifestyle changes that will help them to lower their LDL cholesterol and raise their HDL cholesterol.

    Detecting and Controlling High Cholesterol

    Current guidelines recommend aggressive drug therapy and lifestyle changes for seniors, with careful attention to individual circumstances. In addition, the National Cholesterol Education Program (NCEP) advises all adults aged 20 years or older to have their cholesterol checked at least once every five years. This should include a fasting blood test for total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
    Do you know your cholesterol levels? Have you had them tested recently? Check out the tables below to see what the normal and desirable ranges are for each type of cholesterol and triglycerides.
    Total cholesterol
    Less than 200 mg/dL (5.2 mmol/L) Desirable
    200-239 mg/dL (5.2-6.1 mmol/L) Borderline high
    240 or higher (6.2 mmol/L) High
    mg/dL = milligrams per deciliter (mmol/L = millimoles per liter)
    LDL (bad) cholesterol
    Less than 100 mg/dL (2.6 mmol/L) Optimal
    100-129 mg/dL (2.6-3.3 mmol/L) Near optimal/above optimal
    130-159 mg/dL (3.4-4.0 mmol/L) Borderline high
    160-189 mg/dL (4.1-4.8 mmol/L) High
    190 mg/dL (4.9 mmol/L) or higher Very high
    mg/dL = milligrams per deciliter (mmol/L = millimoles per liter)
    HDL (good) cholesterol
    Less than 40 mg/dL (1.0 mmol/L) Low
    60 mg/dL or higher (1.6 mmol/L) Desirable
    mg/dL = milligrams per deciliter (mmol/L = millimoles per liter)
    Less than150 mg/dL (1.7 mmol/L) Normal
    150-199 mg/dl (1.7-2.2 mmol/L) Borderline high
    200 or higher (2.3 mmol/L) High
    500 or higher (5.7 mmol/L) Very high
    mg/dL = milligrams per deciliter (mmol/L = millimoles per liter)

    Factors That Worsen Cholesterol Risk

    If you have unhealthy amounts of cholesterol or other fats in your blood, the guidelines advise treatment based on your level of risk. The most aggressive therapy is warranted for those at highest risk for heart disease, says NCEP. This includes people with the following conditions:
    • Established coronary heart disease
    • Hardening of the arteries
    • History of a stroke or warning stroke
    • Diabetes
    Lifestyle changes or cholesterol-lowering drugs are also recommended if you have two or more factors that accentuate your risk. These are the factors:
    • Age: Men over 45 and women over 55
    • Cigarette smoking
    • High blood pressure (even if controlled)
    • HDL (good) cholesterol less than 40 mg/dL (1.0 mmol/L)
    • Family history of premature heart disease (in a brother or father under age 55, or a sister or mother under age 65)
    Ask your healthcare provider about your cholesterol. It really counts—for women and men of all ages—when it comes to preventing heart disease.


    American Heart Association http://www.heart.org/

    National Cholesterol Education Program http://hin.nhlbi.nih.gov/ncep.htm

    Theheart.org http://www.theheart.org/


    Healthy Canadians http://www.healthycanadians.gc.ca/

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com/


    At-a-glance: what yo uneed to know about high blood cholesterol. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/heart/chol/cholesterol%5Fatglance.pdf. Accessed September 16, 2011.

    NCEP ATP III guidelines. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Accessed September 16, 2011.

    Women and cholesterol. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Cholesterol/UnderstandYourRiskforHighCholesterol/Women-and-Cholesterol%5FUCM%5F305565%5FArticle.jsp. Updated June 14, 2011. Accessed September 19, 2011.

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