According to the Centers for Disease Control and Prevention, cholesterol buildup in the arteries of the heart is a major risk factor for heart disease, which is the leading cause of death in women. Higher cholesterol levels in the blood can increase your chances of developing heart disease or having a heart attack. The term "heart disease" refers to a variety of heart conditions, including coronary artery disease and heart attack, according to the CDC. Although heart disease is sometimes thought to be a man's disease, nearly as many women as men die from it in the United States each year.

Cholesterol, according to Jacquelyn Cafasso, is a waxy fat that your body uses to make cells, hormones, and other important substances such as vitamin D and bile (a fluid that helps with digestion). Lipoproteins are cholesterol particles that are packaged and transported through your bloodstream. Lipoproteins are classified into two types. LDL (low-density lipoprotein) cholesterol, also known as "bad cholesterol," transports cholesterol to where it is required in the body. HDL (high-density lipoprotein) cholesterol, also known as "good cholesterol," transports cholesterol back to the liver, where it is broken down. Why do women react differently to Cholesterol? According to Dr. Erin Donnelly Michos of John Hopkins Medicine, women have higher levels of HDL cholesterol than men because the female sex hormone estrogen appears to boost this good cholesterol. But, as with so many other things, plus everything changes during menopause. Many women experience a change in their cholesterol levels at this point, with total and LDL cholesterol rising and HDL cholesterol falling. This is why women who hSSad low cholesterol during their reproductive years may develop high cholesterol later in life. Of course, genetics and lifestyle factors can also play a significant role.

Although some women have no symptoms, others may experience angina (dull and heavy or sharp chest pain or discomfort), pain in the neck, jaw, or throat, or pain in the upper abdomen or back, according to the CDC. These symptoms may occur while you are resting or performing routine daily activities. Other symptoms that women may experience include nausea, vomiting, and fatigue. How is cholesterol different in men and women? Women have higher levels of HDL cholesterol than men, owing to estrogen, a female sex hormone. According to the National Institutes of Health, cholesterol levels in women differ depending on the stage of the menstrual cycle due to changes in estrogen levels. As estrogen levels rise, so does HDL cholesterol, peaking around the time of ovulation. LDL and total cholesterol levels, on the other hand, decrease as estrogen levels rise, reaching a low just before menstruation. Many women experience a change in their cholesterol levels when they reach menopause between the ages of 50 and 55.

Joyce Oen-Hsiao defines high cholesterol as having a total cholesterol level greater than 200 milligrams per deciliter (mg/dL). This is true for both men and women over the age of 20. An HDL level of less than 50 mg/dL is considered a major risk factor for heart disease in women. HDL levels greater than 60 mg/dL may reduce the risk of heart disease. If you don't have heart disease, try to keep your LDL levels below 100 mg/dL, and below 70 mg/dL if you have heart disease or a number of risk factors for heart disease, such as diabetes, being over 55, smoking, high blood pressure, or a family history of heart disease.

According to Joyce Oen-Hsiao, the first step toward understanding your risk of heart disease is having your cholesterol levels checked by a doctor. There are several ways to lower cholesterol, including medications prescribed by your doctor. Statins are the most common drug prescribed to treat high cholesterol. If statins don't work, your doctor may switch you to a different medication, especially if you have a high risk of having a heart attack or stroke, or if you have familial hypercholesterolemia. Furthermore, diet and lifestyle are crucial in lowering cholesterol levels.

Here are some lifestyle recommendations to help you lower or maintain healthy cholesterol levels:

• Keep a healthy body weight.
• If you smoke, you should stop.
• Exercise for at least 30 minutes per day, 5 days per week or more.
• Eat a heart-healthy diet rich in fruits, vegetables, lean protein, fiber, and monounsaturated and polyunsaturated fats, such as those found in fatty fish (salmon, trout, tuna) and nuts.
• Avoid foods high in sugar, like candy, soda, and fruit juices.
• Drink alcohol in moderation.

DMO II Marie-Claire Gaas

References:

1. High Cholesterol and Heart Disease in Women

Medically reviewed by Joyce Oen-Hsiao, MD, FACC — By Jacquelyn Cafasso on January 24, 2021

https://www.healthline.com/health/high-cholesterol/high-cholesterol-and-heart-disease-in-women#:~:text=Cholesterol%20that%20builds%20up%20in,or%20having%20a%20heart%20attack.

2. Why Cholesterol Matters for Women

Erin Donnelly Michos, M.D., M.H.S.

https://www.hopkinsmedicine.org/health/wellness-and-prevention/why-cholesterol-matters-for-women

3. Women and Heart Disease

Centers for Disease Control and Prevention

https://www.cdc.gov/heartdisease/women.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fdhdsp%2Fdata_statistics%2Ffact_sheets%2Ffs_women_heart.htm