“Why Cholesterol Matters for Women?”

 

Ah, cholesterol and triglycerides. We hear about them all the time. Even foods that might seem good for you on the surface, like fruit-filled yogurt or bran muffins, can contribute to abnormal levels if they contain too much saturated fat or refined sugar, says Erin Michos, M.D., associate director of preventive cardiology at the Ciccarone Center for the Prevention of Heart Disease. What’s more, many women are at risk for high cholesterol and don’t realize it. “Approximately 45 percent of women over the age of 20 have a total cholesterol of 200 mg/dl and above, which is considered elevated — but a survey by the American Heart Association found that 76 percent of women say they don’t even know what their cholesterol values are,” Michos says. Scarier still: Triglycerides, a type of blood fat typically measured alongside cholesterol, are even more risky in women compared with men. This is a problem because women’s cholesterol levels can fluctuate quite a bit after menopause and tend to increase with age, putting us at greater risk of heart disease and stroke. Knowing your cholesterol numbers and how to control them is a big step toward staying healthy.

UNDERSTANDING THE HIGHS AND LOWS OF CHOLESTEROL: You know that too much is dangerous. But what is cholesterol, anyway? Where does it come from? And is it all bad? Cholesterol is a waxy substance that is found in every cell in the body. It’s either made by the body or absorbed from food. Your body needs cholesterol to make important steroid hormones such as estrogen, progesterone and vitamin D. It’s also used to make bile acids in the liver; these absorb fat during digestion. So, some cholesterol is necessary — but bad cholesterol is something you can do without. Excess bad cholesterol in the bloodstream can deposit into the body’s arteries. These deposits are called plaques and result in atherosclerosis or hardening of the arteries. This is the major cause of heart attacks, strokes and other vascular problems. Your total cholesterol level is a measure of the total amount of cholesterol circulating in your bloodstream, which includes several components:

LDL CHOLESTEROL: LDL stands for “low-density lipoprotein.” This is known as the “bad” cholesterol, which directly contributes to plaque buildup in the arteries. Very low-density lipoprotein, or VLDL cholesterol, is another type, which is a precursor to LDL.

TOTAL CHOLESTEROL is VLDL cholesterol plus LDL cholesterol plus HDL cholesterol.

HDL CHOLESTEROL: HDL stands for “high-density lipoprotein.” Experts think at optimal levels (around 50 mg/dl) it might help the body get rid of LDL cholesterol.

SO, BITS OF THIS STUFF CIRCULATE THROUGH YOUR SYSTEM, AND HERE’S WHAT HAPPENS: The bad parts – the LDL particles – like to stick to the lining of your arteries, like soap scum in pipes. As it sticks there, it generates an inflammatory response, and your body starts converting it into plaque. Plaque in your blood vessels makes them stiffer and narrower, restricting blood flow to vital organs such as your brain and heart muscle, leading to high blood pressure. Additionally, chunks can break off and cause a heart attack or a stroke. And guess what? This buildup can start as early as your 20s.

WHAT TO KNOW ABOUT TRIGLYCERIDES: In addition to cholesterol, you might hear about your triglycerides, another kind of fat found in the bloodstream. Women should pay particular attention to this. “A high level of triglycerides seems to predict an even greater risk for heart disease in women compared with men,” says Michos. When you take in more calories than you need, your body converts the extra calories into triglycerides, which are then stored in fat cells. Triglycerides are used by the body for energy, but people with excess triglycerides have higher risk of medical problems, including cardiovascular disease. Drinking a lot of alcohol and eating foods containing simple carbohydrates (sugary and starchy foods), saturated fats and trans fats contributes to high triglycerides. High levels may also be caused by health conditions such as diabetes, an underactive thyroid, obesity, polycystic ovary syndrome or kidney disease. Triglycerides also circulate in the bloodstream on particles that may contribute to plaque formation. Many people with high triglycerides have other risk factors for atherosclerosis, including high LDL levels or low HDL levels, or abnormal blood sugar (glucose) levels. Genetic studies have also shown some association between triglycerides and cardiovascular disease.

WHAT’S YOUR CHOLESTEROL LEVEL, ANYWAY? A standard lipid blood test usually measures the concentration of total cholesterol, HDL cholesterol, and triglycerides levels. The LDL-cholesterol level is typically estimated from these numbers using a well-established formula that has been more recently revised and improved by researchers at Johns Hopkins. So, what are your target numbers? According to Michos, an ideal LDL cholesterol level should be less than 70 mg/dl, and a woman’s HDL cholesterol level ideally should be close to 50 mg/dl. Triglycerides should be less than 150 mg/dl. As Michos notes, total cholesterol levels well below 200 mg/dl are best. 

WHY CHOLESTEROL AFFECTS WOMEN DIFFERENTLY? In general, women have higher levels of HDL cholesterol than men because the female sex hormone estrogen seems to boost this good cholesterol. But, like so much else, everything changes at menopause. At this point, many women experience a change in their cholesterol levels — total and LDL cholesterol rise and HDL cholesterol falls. This is why women who had favorable cholesterol values during their childbearing years might end up with elevated cholesterol later in life. Of course, genetics and lifestyle factors can play big roles, too. 

HOW TO LOWER YOUR CHOLESTEROL? If you’ve been told that you have high cholesterol — or you just want to prevent it — what can you do? There are several ways to manage it, including:

MEDICATION: Depending on your overall cardiovascular disease risk, you might be treated with a cholesterol-lowering medication, such as a statin. The decision to use a statin is based on a woman’s overall risk for heart attack and stroke including all these factors and the LDL cholesterol value. If you already have vascular disease or evidence of atherosclerosis, or if you are at high risk for cardiovascular disease, a statin for prevention is strongly recommended because this treats the plaque in the arteries, and lowers LDL cholesterol, Michos says.

DIET AND LIFESTYLE: “Diet and lifestyle are very important to help maintain healthy cholesterol levels. Even for women who are recommended to take cholesterol-lowering medications, a healthy lifestyle helps these drugs work better,” says Michos. Here’s how to maintain a lifestyle that promotes healthy cholesterol levels:

Maintain a healthy body weight.

Don’t smoke.

Exercise for at least 30 minutes five or more days per week.

Eat a diet rich in fruits, vegetables, lean protein and high amounts of soluble fiber such as beans and oats, which can reduce LDL.

Avoid sugar-sweetened drinks and fruit juices — opt for water and unsweetened tea instead — and minimize your intake of other simple carbohydrates like baked goods and candy.

Drink alcohol in moderation, especially if you have elevated triglycerides.

Consider the Mediterranean diet, which is rich in fruits, vegetables, grainy breads and fish. Use olive oil (instead of butter) and spices (instead of salt).

Eat monounsaturated and polyunsaturated fats — such as those found in olive oil, nuts and fatty fish like salmon. They can actually have a positive effect on cholesterol, Michos says, by reducing the amount of LDL in the blood and reducing inflammation in the arteries, especially when they replace saturated fats in the diet.

Add these to your shopping list:

Fatty fish such as salmon, trout, mackerel, sardines and albacore tuna

Nuts, including walnuts, pecans, almonds and hazelnuts

Olive oil to drizzle lightly over your salads and vegetables

While nobody wants to have high cholesterol, there are plenty of ways to keep it in check.  “With regular checkups and attention to what you eat, it’s possible to manage your cholesterol and blood fats to keep your heart healthy,” says Michos.

REVIEWED BY: Erin Donnelly Michos, M.D., M.H.S.; Johns Hopkins Medicine

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“Blood Pressure Often Differs Widely Between Arms”

 

Blood pressure readings between the two arms can be different, and that disparity can sometimes be a warning sign of heart trouble down the road. That's the finding of an analysis of 24 past studies: When people have at least a 5-point difference in blood pressure between the two arms, their risk of heart attack, stroke or premature death inches up. And the greater the difference, the more those risks climb. Experts said the findings give more support to something that's been advocated, but not commonly done by doctors and nurses: Checking patients' blood pressure in both arms. "Unfortunately, blood pressure is not routinely measured in both arms," said Dr. Jeffrey Berger, a cardiologist who was not involved in the study. "But I think it should be." Berger directs the Center for the Prevention of Cardiovascular Disease at NYU Langone Health in New York City. He said he always checks blood pressure in both arms and thinks it should be a matter of routine in all patients. "It's such a simple thing to do," Berger said. It's not that the blood pressure difference, itself, is the problem. But a discrepancy between arms might be a sign of early atherosclerosis that is developing asymmetrically, Berger explained. Atherosclerosis refers to a hardening and narrowing in the arteries that, eventually, could lead to heart disease or stroke. Measuring blood pressure in both arms gives doctors "a simple way of noticing possible arterial stiffening," said Dr. Christopher Clark, lead researcher on the new analysis.

There's no way to "fix" between-arm discrepancies, but that's not the point, said Clark, a clinical senior lecturer at the University of Exeter Medical School in the United Kingdom. Instead, he explained, doctors can consider between-arm differences one "marker" of a patient's heart disease risk. And then what? Berger said it depends on a patient's overall health. Eating more healthfully and getting regular exercise is always wise, he said, but some people might need medication, like a statin to ward off cardiovascular trouble.

The findings, published online Dec. 21 in the journal Hypertension, are based on 24 studies from around the world, involving almost 54,000 adults in all. Over 10 years, 11% had a fatal or non-fatal heart attack or stroke. It's normal, Clark said, to have a few points of variation in blood pressure between the two arms -- due to anatomy and the fact that one hand is typically dominant. "Our interest was to identify when that difference is large enough to be regarded as signifying more than this," Clark said. "When is the difference large enough to suggest a change in the arteries that might signify additional risk of strokes or heart attacks?" Overall, his team found, people's risks started to climb when the two arms showed at least a 5-point difference in systolic blood pressure (the "top" number in a blood pressure reading). For each 1-point increase, the risk of dying from heart disease causes in the next 10 years rose by 1% to 2%. Meanwhile, the odds of suffering a first-time heart problem or stroke also crept up. Those increases were small, but the researchers said that a 10-point difference in systolic pressure between arms should be considered the "upper limit of normal."

Between-arm differences are more common in people with high blood pressure, Clark said, but people with normal readings can have them, too. The phenomenon matters more for someone with high blood pressure or other risk factors, like diabetes and high cholesterol, he added. Berger said that it's not clear why so few health care providers measure blood pressure in both arms. "This is not a new finding," he said of the current study. "It's been shown many times." For now, Berger suggested patients ask questions the next time they have a blood pressure check: If it's not being done in both arms, why not? As for home blood pressure monitoring, he said, if people repeatedly detect a significant difference between the arms, they should tell their doctor.

Clark was also in favor of doctors checking both arms, at least once -- in part to get a more accurate gauge of patients' blood pressure. If one arm has a higher reading, he said, then future measurements should be taken on that arm.

BY: Amy Norton, HealthDay Reporter

MORE INFORMATION:

The American Heart Association has more on blood pressure readings.

SOURCES: Christopher Clark, MD, PhD, clinical senior lecturer, University of Exeter Medical School, Exeter, U.K.; Jeffrey Berger, MD, director, Center for the Prevention of Cardiovascular Disease, NYU Langone Health, New York City; Hypertension, Dec. 21, 2020, online

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“Foods That Bait Heart Disease”

Sugar, Salt, Fat: Over time, high amounts of salt, sugar, saturated fat, and refined carbs raise your risk for a heart attack or stroke. If you’re worried about your heart, you’ll want to keep these out of regular rotation. But rather than fixate on any one bad food, it’s wise to focus on your overall diet. You can still have these things if you mostly eat heart-healthy fruits and vegetables, whole grains, lean protein, and low-fat dairy.

Bacon: More than half of bacon’s calories come from saturated fat, which can raise your low-density lipoprotein (LDL), or bad cholesterol, and boost your chance of a heart attack or stroke. It’s full of salt, which bumps up your blood pressure and makes your heart work harder. High amounts of sodium (the main part of salt) can lead to stroke, heart disease, and heart failure. Bacon’s added preservatives are linked to these issues as well.

Red Meat: Eating too much beef, lamb, and pork may raise your odds for heart disease and diabetes. It may be because they’re high in saturated fat, which can boost cholesterol. More recent studies point to how gut bacteria process a part of the meat called L-carnitine. Limit your portions. Also, look for lean cuts like round, sirloin, and extra-lean ground beef.

Soda: Having small amounts of added sugar isn’t harmful, but a can of soda has more added sugar than experts recommend for a whole day. Soda drinkers tend to gain more weight and are more likely to be obese and have type 2 diabetes, high blood pressure, and heart disease. And while the science is still fuzzy on diet drinks, some research links them to weight gain and strokes. Your best bet is plain, carbonated, or unsweetened flavored water.

Baked Goods: Cookies, cakes, and muffins should be rare treats. They’re typically loaded with added sugar, which leads to weight gain. They’re also linked to higher triglyceride levels, and that can lead to heart disease. Their main ingredient is usually white flour, which may spike your blood sugar and make you hungrier. Make healthier treats: Swap in whole-wheat flour, trim the sugar, and use liquid plant oils instead of butter or shortening.

Processed Meats: Hot dogs, sausage, salami, and lunch meat are the worst types of meats for your heart. They have high amounts of salt, and most are high in saturated fat. When it comes to deli meats, turkey is better for you than salami because it doesn’t have the saturated fat. But it still has a fair amount of sodium, so it isn’t as heart-healthy as fresh sliced turkey breast.

White Rice, Bread, and Pasta: Rice, bread, pasta, and snacks made from white flour are missing their healthy fiber, vitamins, and minerals. Refined grains quickly convert to sugar, which your body stores as fat. A diet high in refined grains can cause belly fat, which studies link to heart disease and type 2 diabetes. Try to get at least half your grains from whole grains like brown rice, oats, and whole wheat. When you shop, look for the words "100% whole grain."

Pizza: Pizza can be healthy if you make it the right way, but most take-out pizza and frozen pies have staggering amounts of sodium, fat, and calories, all of which can raise your risk of a heart attack. When you order out, opt for a thin crust (whole wheat if possible), ask for less cheese, pile on the veggies, and skip the pepperoni or sausage, which are loaded with salt. For the most heart-healthy pizza, make it yourself.

  

Alcohol: Moderate drinking won’t harm your heart unless you have high blood pressure or high triglycerides, a type of fat in your blood that can boost your odds of heart disease. Heavy drinking, on the other hand, can lead to high blood pressure, heart failure, strokes, and weight gain. So, if you don’t already drink, don’t start.

Butter: Butter is high in saturated fat, which can raise your bad cholesterol and make heart disease more likely. You're better off to replace butter with olive oil or vegetable oil-based spreads, which contain heart-healthy mono- and polyunsaturated fats. If you have high cholesterol, a spread with stanol is even better. Regular use can help lower your LDL cholesterol levels.

Flavored, Full-Fat Yogurt: Yogurt can be a super source of nutrition. Eating it regularly might protect you from high blood pressure. But watch the kind you buy. Flavored yogurts are full of added sugar, with its links to weight gain, high blood pressure, inflammation, and heart disease. For the healthiest choice, get plain low-fat yogurt and add your own fresh fruit, cinnamon, or vanilla for flavor.

French Fries: The deep-fried potatoes from restaurants and fast-food places have lots of fat and salt, which is bad news for your heart. One study found that people who ate french fries or hash browns 2 to 3 times a week were more likely to die early. If you indulge, get the smallest portion possible or split your order. Even better: Make your own oven-baked fries with heart-healthy olive oil. They’ll be even better for you if you use sweet potatoes.

Fried Chicken: Deep-frying chicken adds calories, fat, and sodium to an otherwise healthy food. Studies have linked fried food with type 2 diabetes, obesity, and high blood pressure -- all of which raise your odds of heart failure. For a crispy but healthier choice, bread skinless chicken breasts in whole-wheat flour and bake instead of frying.

Canned Soup: Soup can be an easy way to get more vegetables, protein, and fiber. But watch out for unhealthy ingredients. Canned soup often has lots of sodium, which can cause high blood pressure, heart attack, stroke, and heart failure. And any cream-based soup has unhealthy saturated fat. The healthiest way to enjoy soup is to make it from scratch with a low-sodium broth. If you do buy prepared soup, check the label for the least salt and fat.

Ranch Dressing: The main ingredients of this popular dressing are typically buttermilk, salt, and sugar. This makes it high in fat, sodium, and calories. None of that’s good for your heart. You can make a healthier version of your favorite creamy dressings by blending low-fat sour cream or cottage cheese with low-fat buttermilk and fresh herbs like dill, tarragon, or chives.

Ice Cream: Ice cream is high in sugar, calories, and saturated fat, so save it for a special treat. Eating foods loaded with fat and sugar leads to weight gain. It can also drive up your triglycerides and lead to a heart attack. Cut your calories and fat by choosing sorbet, low-fat or nonfat frozen yogurt, or frozen fruit bars. Check the label for the least amount of sugar and saturated fat.

Potato Chips: Potato chips are one of the foods that contribute most to weight gain. And not only are they loaded with saturated fat, they’re also covered in salt -- which is also linked to heart disease. Skip the lower-sodium or low-fat potato chips. They’ll just leave you hungry again. The most nutritious snacks combine healthy proteins, carbs, and fats, like whole-grain crackers with low-fat cheese or homemade popcorn tossed with olive oil.

Reviewed by: James Beckerman, MD, FACC on February 12, 2019

Sources:

Jo Ann Carson, PhD, past nutrition committee chair, American Heart Association; professor of clinical nutrition, University of Texas Southwestern Medical Center, Fort Worth.
American Heart Association: “Saturated Fat,” “Meat, Poultry, and Fish: Picking Healthy Proteins,” “Sugar 101,” “Triglycerides: Frequently Asked Questions,” “Are Some Breads Getting a Bad Rap?” “Alcohol and Heart Health,” “Oven-Fried Chicken with Roasted Potato Wedges,” “Healthy Swaps for Common Foods.”
News release, American Heart Association.
Harvard School of Public Health: “Health Risks and Disease Related to Salt and Sodium,” “Soft Drinks and Disease,” “The Great Muffin Makeover.”
News release, Harvard School of Public Health.
Sodium Breakup: “America Has Some of the World’s Saltiest Pizza -- Here’s 5 Tips for a Healthier Slice.”
CDC: “Top 10 Sources of Sodium.”
The American Journal of Clinical Nutrition: “Fried Potato Consumption is Associated with Elevated Mortality: An 8-yr longitudinal cohort study.”
Journal of the American Heart Association: “Consumption of Fried Foods and risk of Heart Failure in the Physicians’ Health Study.”
Eatforhealth.gov.au: “Fat.”
University of California, San Francisco: “How Much is Too Much: The growing concern over too much added sugar in our diets.”

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)
The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.