Dyslipidemia in Women

Mortality from cardiovascular disease (CVD) in women has increased
over the past ten years. There have been more deaths among women
than among men.  This factor may be attributed to gender disparities in the diagnosis, treatment and follow-up care. CVD also affects a high percentage of adult women and men over the age of 60.

Risk factors for CVD include hypertension, abdominal obesity, elevated triglycerides, low HDL (high density lipoprotein) cholesterol, sedentary lifestyle, and poor nutrition. Individuals at special risk have hypertension,
the metabolic syndrome and diabetes. The cardiovascular risk of diabetics
is similar to those individuals who have coronary heart disease (CHD). Diabetics are more likely to suffer stroke, MI, or heart failure than non-diabetics and after having a stroke, etc, their outcome is poorer.

Women who have three or more risk factors for metabolic syndrome are at greater risk for CVD than their counterparts who have no risk factors. The risk for coronary heart disease (CHD) is greater in postmenopausal women and increases with age.

Women usually maintain their higher levels of HDL-C throughout their lifespan in relation to their normal lower levels of low density lipoprotein cholesterol (LDL-C). Hormonal effects on lipid profile levels in women, is quite noticeable.  Nulliparous women have higher HDL-C than parous women. The hormones in oral contraceptives (OCs) may increase triglycerides.  In perimenopausal women the LDL-C levels rise and the
HDL-C levels remain the same or decrease. Although hormone replacement therapy (HT) may have a positive effect on the lipid profile it does not reduce one’s risk of CVD. 

HT and Lipid Profile
Estrogen	Estrogen & Progestin
Triglyceride increases	Triglyceride increases
HDL-C increases	HDL-C attenuated
LDL-C decreases	LDL-C decreases

Elevated triglyceride and low HDL-C levels are strongest risk factors for CHD in women.

Optimal Levels for LDL-C
Low Risk Women	<130 mg/dL
Moderate to high risk (Coronary artery disease-CAD)	<100 mg /dL
Highest risk women (Diabetes, CAD)	<70 mg/dL

Lifestyle modifications for improvements in lipid profile

• Decrease fat intake; change to poly-and mono-unsaturated fats
• Maintain a low fat, low cholesterol diet
• Increase exercise-moderate intensity. An increase in HDL-C is time sensitive with an incremental increase over a two year period.
• Eat a diet high in fruits and vegetables of various colors