Women at Risk For High Cholesterol

Even a woman who routinely aces her medical tests may earn less-than-perfect scores at cutting-edge preventive health centers. At some health centers the goal is to get women to lower risk factors beyond standard recommendations. Here are some answers to your questions on the numbers that translate into maximum protection.

What cholesterol levels do you look for? New national guidelines say that LDL (bad) cholesterol levels less than 100 are optimal, and that patients with a previous heart attack or diabetes should level for levels below 70. We say that less than 75 is optimal for healthy people. For HDL (good) cholesterol, guide lines are that over 50 is normal for women; we want levels of 65 or higher.

What about blood pressure? You should pretty much go with the guidelines: under 120/80. But doctors tell patients that even lower is better. If your pressure rises in the doctor's office, keep in mind that it's probably also going up when you're stressed at work or stuck in traffic-that can be a risk.

How can women achieve these superlow numbers? If you have only a borderline risk, you should talk about diet, exercise, and stress reduction. Often, just by making lifestyle changes, women can get a 20 percent improvement in their cholesterol levels.

Does that always work? No. Even women who eat well and are fit may have problems with cholesterol. In that case, it's probably genetic. That's when medication can really add to what you do on your own.

What's the takeaway message for women? Stay on top of your tests. Ask to get a copy of lab results, not just a call saying everything's OK. Since labs vary, it's best to track changes in your cholesterol by the ratio of total cholesterol to HDL (divide the total by the HDL number). What do you look for? The American Heart Association says you should aim for a ratio below 5: 1; we believe the optimal is 3.5: 1. And if your ratio, weight, or blood pressure start to creep up, take action. It's much harder to reverse things once you have heart disease or diabetes.