Women’s heart health post-menopause: Understanding your target LDL cholesterol levels

Heart disease has historically been perceived as primarily affecting men, but its impact on women is equally significant, albeit often manifested differently. In India, the prevalence of heart disease in women ranges from 3% to 13% and has increased by almost 300% over the past two decades. In fact, recent studies show that the prevalence of heart failure in Indian women has more than doubled from 2000 to 2015.With these alarming statistics, it is essential to acknowledge these gender-specific distinctions, especially concerning conditions such as atherosclerotic cardiovascular disease (ASCVD). ASCVD refers to the narrowing and hardening of arteries due to the buildup of plaque, increasing the risk of heart attack and stroke.Impact of ASCVD in WomenStudies reveal that ASCVD affects women differently in terms of symptoms, risk factors, and outcomes. Women often develop ASCVD later in life, typically after menopause, and may experience symptoms such as fatigue, shortness of breath, or discomfort in the jaw, neck, back, or abdomen. These symptoms are often overlooked or misinterpreted, delaying diagnosis and treatment.Image: CanvaWhile men and women share common ASCVD risk factors like high cholesterol, high blood pressure, diabetes, and smoking, women have additional risks such as pregnancy-related conditions (e.g., gestational diabetes, pre-eclampsia) and hormonal influences (e.g., polycystic ovary syndrome, menopause). As women age, their risk of developing ASCVD increases due to the reduction in hormone levels like estrogen caused by menopause.Dr. Zakia Khan, Cardiologist, Fortis Hospital, Mumbai, said, “Monitoring cholesterol levels helps detect high LDL-C early. Women should typically start cholesterol screening by the age of 18. When they initially visit, a lot of women don’t know about their condition. Hormonal fluctuations and lifestyle decisions can raise cholesterol levels, which, if unchecked, can result in cardiovascular diseases such ASCVD. The perimenopausal period, the transition during the start of menopause, increases the risk of ASCVD. This risk is further elevated in the presence of comorbidities such as diabetes mellitus and hypertension. Other conventional risk factors for women include PCOD (polycystic ovary disease), pre-eclampsia, use of oral contraceptive pills, and chronic autoimmune arthritis. For risk factors to be modified and treatment to be started on time, early screening and routine lipid profile checks are essential. Every patient needs personalized prevention plans based on their unique LDL-C targets. Being proactive ensure in maintaining a healthy heart.”The Relationship Between ASCVD and CholesterolASCVD is a long-term health problem where cholesterol builds up in arteries. Over time, the formation of cholesterol plaque in the arteries leads to their narrowing and hardening. As the plaque continues to grow, it can lead to several severe health issues like heart attacks and strokes.Distinguishing Between Good and Bad CholesterolCholesterol is vital for the body’s functioning, but an imbalance can be harmful. Low-density lipoprotein (LDL) cholesterol, often labelled as “bad” cholesterol, contributes to ASCVD by promoting plaque buildup in the arteries. Conversely, high-density lipoprotein (HDL) cholesterol, known as “good” cholesterol, helps remove LDL cholesterol from the bloodstream, reducing the risk of arterial plaque formation.The Importance of LDL Cholesterol Levels in Women’s Heart HealthLDL cholesterol plays a central role in the development of ASCVD, making it a critical focus for women’s heart health. Knowing one’s LDL cholesterol levels through regular lipid profile tests and cholesterol monitoring are essential for managing this risk.Dr. Sandeep Chopra, Additional Director Cardiology, Fortis Hospital, Ludhiana, said, “I emphasize the significance of early cholesterol screening for women, because their symptoms often go unnoticed. Women should typically start cholesterol screening in their thirties. At least 40% patients I see have elevated LDL-C levels, a key contributor to ASCVD.”Why Talking to Your Doctor is ImportantGiven the diverse risk factors and manifestations of ASCVD in women, a one-size-fits-all approach to treatment is insufficient. It is important to have open and honest conversations with your doctor about your heart health. Discuss your reproductive history, hormonal status, lifestyle, and any genetic predispositions. By working together to set personalized LDL cholesterol targets, you and your doctor can develop a prevention plan tailored to your unique health profile.Heart health requires a holistic approach, prioritizing cholesterol management through regular monitoring, personalized care plans, and effective doctor-patient communication. By understanding and managing LDL cholesterol levels, women can take proactive steps to safeguard their heart health and improve their overall well-being.Empower your health: How PrEP & testing can prevent HIV


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