Health Concerns - High Cholesterol
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Effects of High Cholesterol

Many studies found that women with higher total cholesterol levels also have higher rates of coronary artery disease. After menopause, the development of atherosclerosis (a buildup of cholesterol in the coronary arteries) can progress. Left untreated, atherosclerosis can eventually cause a heart attack by blocking the supply of blood to the heart.

Many women are poorly screened for elevated cholesterol. A recent report by Dr. Mike Nichol revealed 35% of women at risk for cardiovascular disease did not have cholesterol screening within the past five years. Elevated cholesterol is one of the most important contributors to a woman's risk of developing heart disease

All women should be aware of their cholesterol numbers. Cholesterol is measured in the following ways:

  • Total cholesterol is a number that includes both types of types of cholesterol:
    • HDL—the good’ cholesterol and
    • LDL—the ‘bad’ cholesterol
  • Triglycerides
    • Another form of ‘fat’ in your blood stream.

The amount of total cholesterol, HDL, LDL and triglycerides are used to determine the risk of CVD in women.

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.

Total Cholesterol
Level Category
Less than 200 mg/dL
200-239 mg/dL
Borderline High
240 mg/dL and above

* Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

LDL Cholesterol Level
LDL-Cholesterol Category
Less than 100 mg/dL
100-129 mg/dL
Near optimal/above optimal
130-159 mg/dL
Borderline high
160-189 mg/dL
190 mg/dL and above
Very high

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.

Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

Controlling Cholesterol Risk
The National Cholesterol Education Program (NCEP) panel of experts has outlined CVD risk factors. The following are things you can do something about:

  • Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
  • Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
  • Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.

Things you cannot do anything about also can affect cholesterol levels. These include:

  • Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise.
  • Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

If behavioral modification is has been attempted and elevated cholesterol levels persist, then medical therapy is very effective. A group of drugs called 'statins' have been proven to lower CVD events and deaths when used to manage elevated cholesterol levels.

Soy has been found to be helpful for lowering the risk of heart disease. A review of numerous studies on the effects of soy rich diets found reduced total cholesterol (9%), bad (LDL) cholesterol (13%), and triglycerides (11%) with an average intake of 47 grams of soy per day. Soy phytoestrogen supplementation was found to have a beneficial effect on specific markers in postmenopausal women with diabetes, thus improving their cardiovascular risk profile. The Food and Drug Administration (FDA) has approved soy dietary supplementation. They recommend that 25 grams of soy per day with a prudent diet may reduce the risk of heart disease.

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Recent News:

  1. Postmenopausal women and treatment for high cholesterol.
    The popular group of medications used to treat high cholesterol called ‘statins’ has been shown to reduce the risk of cardiovascular events in post-menopausal women (Circulation 2002;105:2962-7). Data from a large study of over 2700 post-menopausal women (the HERS -or- Heart and Estrogen/progestin Replacement Study) evaluated the impact of 'statin' use on heart attack or death from coronary heart disease. Follow-up was over 4 years. A 21% reduction in heart attack and 33% reduction in death from coronary heart disease was seen in this part of the HERS study. Researchers suggested "the present study...provides, for the first time, evidence that statins may lower total mortality in women. These results...provide substantial additional support for statin use in post-menopausal women with coronary heart disease".

MenopauseRx urges women to have their cholesterol level checked and alter risk factors that are able to be modified.