High cholesterol: Should women worry?

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SAN FRANCISCO

Senior citizens have no reason to obsess about it, nor does anyone under the age of 20. Now two University of California doctors say no healthy woman of any age should be overly concerned about her cholesterol level.

Reviewing nine studies of cholesterol in women, internists Judith Walsh and Deborah Grady found that high cholesterol levels--over 240 milligrams per deciliter total, or more than 130 of the "bad" cholesterol known as LDL--are indeed associated with an increased risk of dying from a heart attack. But heart attacks are rare among young and middle-aged women. Even an elevated risk is small, compared to the heightened danger that high cholesterol levels impart to men-so small that studies have been unable to show a drop in the risk of heart attack death if women lower LDL levels.

"Does this mean that women should stop exercising, go out and gorge on high-fat foods?" says Walsh. "Of course not. But they shouldn't focus on this one number, either. It's one risk factor."

The studies suggest that it is worth using diet and drugs to lower LDL levels in women with additional risk factors, such as diabetes and smoking. And women who already have heart disease can cut their risk of heart attack death by nearly two thirds by lowering their cholesterol.

Doctors already favor a low-fat diet over drugs to treat healthy women with high cholesterol. Walsh says her findings should reassure those whose LDL levels still hover above 240; taking medication may carry worse risks. "We don't know what the long-term side effects are," she says.

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Vital Signs by Benedict Carey and Patricia Long

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