Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2002;65(2):228-229

Heart Disease and Cholesterol

Heart disease is a disease of the arteries that bring blood to the heart muscle. It is the number one killer of American women. The build-up of cholesterol (say: ko-less-tur-all) in the arteries of the heart is an important risk factor for heart disease.

Kinds of Cholesterol

There are two important kinds of cholesterol in your blood. Low-density lipoprotein (LDL) cholesterol is called “bad” cholesterol. High-density lipoprotein (HDL) cholesterol is called “good” cholesterol.

The build-up of LDL cholesterol on the walls of the arteries of your heart can slow the flow of blood through the arteries. It can even block the arteries. If your heart muscle does not get enough oxygen from blood, you can have chest pain called angina (say: an-ji-nah) or a heart attack.

HDL cholesterol helps to remove the bad cholesterol from your blood. Having a high HDL cholesterol level is especially important if you are more than 65 years old.

Your Cholesterol Level

Your doctor will do blood tests to find out your total cholesterol level. Tests can also measure your LDL and HDL cholesterol levels.

Goals for Your Cholesterol Levels

It's best to keep your total cholesterol level below 200. Women of any age should have an HDL level of 40 or higher.

If you already have heart disease or diabetes, or your doctor estimates that your 10-year risk of heart disease is 20 percent or higher, try to keep your LDL level below 100.

If you do not have heart disease or diabetes, but you have two major risk factors, try to keep your LDL cholesterol level below 130. Major risk factors are age over 55; cigarette smoking; high blood pressure; low HDL (less than 40); a father or brother with heart disease before age 55, or a mother or sister with heart disease before age 65.

If you have fewer than two major risk factors, try to keep your LDL level below 160.

Lowering Your Total and LDL Cholesterol Levels

Here are some things you can do:

  • Lose weight if you are overweight.

  • Exercise regularly. For example, walk or ride a bicycle for 30 minutes at least three times a week.

  • Eat fewer high-fat foods, like butter, cheese, meat, and some vegetable fats (palm oil and cocoa butter). Foods that are high in saturated fat should be less than 7 percent of your total daily calories.

  • Eat more high-fiber foods, like vegetables, fruits, grains, and whole-grain breads, cereals, and pasta.

Your doctor can help you plan a heart-healthy diet. If exercising and changing your diet do not help enough, you might need to take a medicine to lower your cholesterol level.

Medicines to Lower Your Cholesterol Level

Medicines called “statins” are most often used to lower cholesterol levels. There are other cholesterol-lowering medicines that your doctor might prescribe, like resins, fibrates, and niacin. If you need to take a medicine to lower your cholesterol level, your doctor will help you find the one that works best for you.

Estrogen replacement therapy (also called hormone therapy) lowers your bad cholesterol level and raises your good cholesterol level. However, studies have not shown that it lowers the risk of heart disease.

Finding More Information

You can learn more about lowering your cholesterol level by contacting these groups:

American Heart Association

(ask for “Women's Health Information”)

The National Heart, Lung, and Blood

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