The fact of the cholesterol matter is-- the higher a woman's blood cholesterol level, the greater her chances are of developing heart disease.  The good news is you can control your cholesterol and lessen your chances for heart attack and heart disease.  Even if you already have heart disease, it is possible to lower your cholesterol and maintain healthy levels.

Women between the ages of 45 and 55 are disappearing into the cholesterol gap between men and women.  At this time, women's cholesterol levels begin to rise higher than men's and their risk of heart disease also increases.  This has to do with the difference between good cholesterol and bad cholesterol.

0.1. Good and Bad Cholesterol

You take the good, you take the bad and there you have: total cholesterol.  Cholesterol is a fat (also known as a lipid) that helps the body stay well-oiled and running.  When your body has too much cholesterol, it gets deposited on the inside of your blood vessels.  This buildup can make the arteries narrower and narrower and less blood is allowed to flow to the heart.  If the vessels become totally obstructed, blood and oxygen cannot reach the heart and the result is a heart attack.

Lipoproteins are the little packages that carry cholesterol through the bloodstream.  There are two kinds of lipoproteins: the good ones (high density lipoprotein or HDL) and the bad ones (low density lipoprotein or LDL).  The good guys help prevent the buildup of plaque by carrying extra bad cholesterol back to the liver to flush it from your body.  Too much of the bad guys (LDL) can lead to cholesterol buildup and block the arteries.  Your goal should be to lower your LDL as much as possible because the higher the levels, the greater your risk is of developing heart disease. Dietary fat and its resulting cholesterol have been linked to heart disease and colon and breast cancer in women.

0.2. Cholesterol profiles

Cholesterol profiles measure both HDL and LDL levels.  So, you can monitor them to determine if they are at healthy levels.  We recommend every women age 20 and older have a lipoprotein profile.  Here are some levels to think about:

0.3. Triglycerides

Another important aspect of your total cholesterol is your level of triglycerides.  This is another type of fat that your body uses to store energy.  They are usually found in small levels in your body, but can be produced more rapidly when you drink alcohol or take in excess calories.

You should aim to keep triglyceride levels below 150 mg/dL by limiting your intake of carbohydrates, cholesterol and saturated fats.  Also, more physical activity, avoiding smoking and alcohol can also help.  Sometimes, medication is needed.

0.4. Cholesterol and Heart Disease

Is my cholesterol putting me at risk for heart disease?

The following risk factors may increase your LDL and the risk of heart disease:

• Smoking
• High blood pressure (140/90 mmHg or higher, or if you are on blood pressure  medication)
• Low HDL cholesterol (less than 40 mg/dL)
• Family history of heart disease (your father or brother before age 55, or your mother or sister before age 65)
• Age (55 or older)
• Metabolic problems (overweight/obesity)
• Triglycerides of 150 or more
• Blood sugar of 100 or more

0.5. Lowering Cholesterol

You can control your cholesterol through lifestyle modifications, medications or a combination of both, also called Therapeutic Lifestyle Changes (TLC).  There are three components to TLC:

1. A cholesterol-lowering diet - lower calories and fats in your diet to avoid increasing your risk of heart disease.  Also, cut back on the sugars.
2. Regular physical activity - physical inactivity raises your risk of heart disease and increases risk factors including blood pressure, diabetes, osteoporosis, etc.
3. Weight management - if you are overweight, you are more likely to develop heart disease even if you have no other risk factors.  Being overweight also increases other risk factors including diabetes, high blood pressure and high blood cholesterol.

If your TLC plan doesn't work to lower your cholesterol, then you might want to think about medications.

0.6. Cholesterol Medications

• Statins - This can lower LDL cholesterol by 20 to 60 percent.  
• Bile Acid Sequestrates - LDL cholesterol can be reduced by about 10 to 20 percent.  This medication is usually prescribed to work along with statins.
• Nicotinic Acid (also called niacin) - lowers total cholesterol (including LDL and triglyceride levels) but raises HDL levels.
• Fibrates - Can reduce triglyceride levels by 20 to 50 percent while increasing HDL by 10 to 15 percent but usually not very effective for lowering LDL levels.
• Ezetimibe - A new class of cholesterol-lowering drug that interferes with the absorption of cholesterol in the intestine.

0.7. Are you at a healthy weight?  

The chart below gives the body mass index for various heights and weights for men and women.  Weight is measured with underwear but no shoes.

Now, interpret your BMI with the following guidelines:

Normal weight BMI=18.5-24.9; Bravo! Try to maintain this weight.

Overweight BMI= 25-29.9; Watch out!  You need to lose weight if you have two or more risk factors for heart disease and are overweight or have a high waist measurement.

Obese BMI= 30 and higher; Talk to your doctor or nutritionist!  You need to lose weight slowly (about ½ to 2 pounds per week).