Three Things Young Women with High Cholesterol Must Do

Some young women have high cholesterol numbers and should be VERY concerned.

A poor cholesterol profile is nothing to sweep under the rug. Here’s what to do.

If you’re a young adult woman and don’t know your cholesterol numbers, it’s time to find out.

Don’t assume they’re “good” just because you’re not overweight or don’t smoke, either.

Cholesterol Numbers

“The first thing is to understand the components that make up your total cholesterol level including the ‘bad’ (LDL) and ‘good’ (HDL) cholesterol,” begins cardiologist Norman E. Lepor, MD, Co-director, Cardiovascular Imaging, Westside Medical Imaging and Clinical Professor of Medicine at UCLA.

“Bad cholesterol infiltrates and ‘hardens’ your arteries by forming plaque, which leads to a type of heart disease called atherosclerosis and puts you at risk for heart attack and stroke,” continues Dr. Lepor.

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“On the other hand, good cholesterol, which tends to be higher in young women, has protective benefits and can help remove bad cholesterol from the arteries.

“In addition to knowing the differences between bad and good cholesterol, women should ensure they talk to their OB/GYN and/or primary care physicians about their cholesterol status and get their levels checked annually.

“This is because having high cholesterol tends to have no symptoms.” You can feel quite fine and still have high bad cholesterol and low good cholesterol.

“Desirable LDL levels in women should be less than 100 mg/dl, and desirable HDL levels should be greater than 50 mg/dl.

“If you have difficulty reaching those levels, you may be referred to a cardiologist or endocrinologist to help you better manage your cholesterol.”

What if your lipid panel reveals undesirable cholesterol numbers?

Dr. Lepor recommends that your second move be an investigation into your family history, if possible, regarding the cholesterol profiles and any heart disease diagnoses among your parents, siblings and grandparents.

However, a relative may have coronary artery disease and/or a poor cholesterol profile and not know it.

The investigation into family history includes “family members dying suddenly, experiencing heart attacks, strokes or undergoing procedures to treat arterial blockages such as stents or bypass surgery,” says Dr. Lepor.

“Young women who have very high LDL levels greater than 190 mg/dl — especially those who have a family history of very high cholesterol and coronary vascular events — may have inherited a genetic cholesterol condition called familial hyperlipidemia (HeFH).

“Women with HeFH are at very high risk of developing coronary vascular complications of atherosclerosis.

“Certain imaging methods can help detect early atherosclerosis such as carotid ultrasounds, coronary calcium assessments or a coronary CT angiography.”

What can a young woman do to lower her bad cholesterol and raise her good cholesterol?

A review of lifestyle habits is the third action that a woman should promptly make and act upon, in the wake of undesirable lipid panel results.

Dr. Lepor advises “to maintain a healthy and active lifestyle and talk to your doctor about the right cholesterol lowering medications for you.”

Just what is a healthy and active lifestyle? Many women believe they lead a healthy and active lifestyle when, in fact, they don’t.

Doing housework does not mean an active lifestyle. Few women don’t clean house. It’s a built-in task of daily living, and therefore, should be regarded as a constant in the equation, rather than a variable.

There are women who clean homes for a living who still have very high LDL cholesterol or even coronary artery disease.

A very strong variable, as far as being a component of heart disease prevention and also improving cholesterol profile, is that of structured, methodical aerobic exercise — on a consistent basis — such as brisk walking, jogging, karate, a fitness class, hiking and playing basketball. Even better is if you add strength training.

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So even if you have three kids under age five and live in a 2,000 square foot house and don’t have a maid, you absolutely need to find time to make structured cardio and strength training routines a part of your life.

Not only does exercise have a direct beneficial impact on the cardiovascular system, it also helps manage body weight.

As for what you should eat, Dr. Lepor explains, “There is no need for fancy diets — you can follow a Mediterranean diet with relatively low carbohydrate levels and healthy protein sources, and you can complement dietary changes with exercise.”

Mediterranean diet

An improvement in diet and the addition of systematic exercise, however, may not be enough to lower the bad cholesterol.

“That’s because cholesterol comes primarily from your liver, rather than the food you eat,” says Dr. Lepor.

“Women with high LDL cholesterol may benefit from early and aggressive treatment.

“This can include cholesterol-lowering agents such as statins, cholesterol absorption inhibitors, ACL inhibitors and PCSK9 inhibitors.

“There is also another medication in our arsenal called Leqvio (inclisiran), a treatment given by a healthcare professional twice a year, after two initial injections, for people with known heart disease on statins who need additional help lowering their LDL cholesterol.

“For these people, Leqvio can help lower bad cholesterol by over 50% and keep it low during each six-month dosing interval.

“However, with any medications, I always encourage people to visit their doctor regularly to discuss any side effects.”

There’s yet another weapon that a young woman can use to improve her cholesterol numbers: fiber.

An increase of five to 10 grams of soluble fiber a day can lower the bad (LDL) cholesterol. Fiber rich foods include lentils, beans, berries and other fruits, and whole grains.