How often should women have their cholesterol checked?
Women should have their cholesterol checked at least by the time of puberty. If it is fine, it should be rechecked at least every five years until age 25. After age 25, annual lipid testing should be standard. Women should have cholesterol evaluated pre and post each pregnancy, as hormone levels can cause significant variations in lipid profiles. Women go through significant hormone variations with puberty, pregnancy, peri-menopause and menopause so it is essential that normal levels be established before these significant events.

If you feel fine is it important to know your cholesterol numbers?
Feeling fine has no bearing on when to check cholesterol, as most women feel perfectly normal right up until the time of a heart attack or stroke. Additionally, many women have cholesterol numbers that appear rather stable and yet may be at tremendous risk so it is essential to get regular medical care. It is also important to realize that many women who have a heart attack or ischemic stroke have symptoms that vary from the classic symptom of chest pain. Specifically, many women report shortness of breath, anxiety, fatigue and inability to sleep. These symptoms are often discounted and ignored, which can have detrimental effects.

My cholesterol results tell me my total cholesterol, triglycerides, HDL and LDL – which number is important?
Elevated cholesterol is a risk factor and should be taken seriously at any age. It was recently reported from the Women’s Health Study that the total cholesterol (TC) –good cholesterol (HDL) ratio (TC/HDL) is the most predictive cholesterol number. Ideally the ratio of TC/HDL should be less than 3.0. Simply relying on one of the values exclusively is often misleading.

Treating cholesterol with lifestyle and diet can be very challenging – at what point should a woman with high cholesterol consider taking medications to lower her cholesterol?
All women need to maximize their lifestyle for overall wellness. A healthy diet along with a daily exercise routine is the most important health decision we can control. Medication to lower cholesterol should be strongly considered for all women who (1) have atherosclerosis (cholesterol build up in the wall of an artery), (2) have Type 2 Diabetes or (3) cannot achieve the National Cholesterol Educational Panel’s guidelines for LDL or non-HDL levels based on their Framingham or Reynold’s risk score (FRS & RRS). Lifestyle should be initiated during all ages and many medical therapies now have FDA approval for use in the pediatric population. Pregnancy is one area where pharmaceutical intervention should be avoided. Women need to realize the FRS and RRS frequently underestimate their risk.

Additional information
Any female interested in being aggressive with preventing a heart attack or stroke should consider additional screening with the painless relatively inexpensive ultrasound (US) scan of their carotid arteries known as carotid IMT (not the more commonly performed duplex US of the carotids) and having a blood test called Lp-PLA2 drawn. This blood test is the only FDA approved test for stroke and heart attack risk assessment. If any significant issues are discovered, they should seek the advice of health care providers who specialize in preventing heart attacks and strokes.

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Post from: Blisstree

Q&A: Cholesterol Concerns for Women

Dr. Peter McCullough:
My name is Dr. Peter McCullough and I’m the Chief of Preventive Medicine at Michigan’s William Beaumont Hospital. My primary practice and research aims are to promote innovative approaches in the prevention of common illnesses including heart disease and stroke.

First, what exactly is an ischemic stroke, and how common is it?

Dr. Peter McCullough:
Ischemic stroke is a stroke that occurs as a result of an obstruction within a blood vessel that supplies blood to the brain. Atherosclerosis is the underlying condition for this type of obstruction which is defined as the development of fatty cholesterol deposits lining the vessel walls causing obstructions.

According to the American Stroke Association, 780,000 strokes are reported annually in the United States with approximately 53 percent occurring in women. Ischemic stroke is the most common type of stroke accounting for approximately 87 percent of stroke cases.

Please tell us about the PLAC Test. What does it detect, and how easy is it to take?

Dr. Peter McCullough:
The PLAC Test is a simple blood test that is performed in a laboratory and measures the amount of Lp-PLA2 (lipoprotein-associated phospholipase A2) which is an enzyme indicating the presence of rupture prone plaque in the blood vessels. Available since 2005, the PLAC Test is the ONLY blood test cleared by the FDA to aid in assessing risk for both coronary heart disease (CHD) and ischemic stroke associated with atherosclerosis.

The PLAC Test is performed at most diagnostic laboratories throughout the United States, including LabCorp, Quest Diagnostics Incorporated, Mayo Medical Laboratories, ARUP Laboratories, Berkeley HeartLab and a number of regional laboratories. It is covered by Medicare and many commercial insurance programs but may trigger a modest out of pocket charge for private insurances that do not cover it.

Is there a certain age group of women that may benefit more from taking the PLAC Test?

Dr. Peter McCullough:
The PLAC Test is recommended in women assessed to be at moderate or high stroke risk by traditional risk assessment. According to a supplement published in the June 2008 edition of The American Journal of Cardiology, these risks include:

• being older than 55;
• high blood pressure
• diabetes
• being of African American decent;
• history of vascular disease such as myocardial infarction or peripheral vascular disease; and
• prior history of stroke.

With that said, any woman with a familial history of heart disease or ischemic stroke should consult their physician about this test.

What changes can the average woman implement now to help reduce the risk of stroke and coronary heart disease?

Dr. Peter McCullough:
Women found to be at an increased risk for coronary heart disease and ischemic stroke can follow intensive treatment programs, such as lifestyle modification, including a healthy diet and weight reduction for most, daily exercise, and therapeutic intervention, including statin drugs and daily aspirin. Importantly, high blood pressure and diabetes need to be expertly managed with multiple medications for the best results.

Do you have anything to add?

Dr. Peter McCullough:
The PLAC test has been a real breakthrough for doctors and patients. A level greater than 230 is clearly elevated and we know that medical treatments which favorably influence the blood vessel blockages lower PLAC levels to 160 or lower. Many doctors are using this test along with the cholesterol panel, blood sugar, and blood pressure as a “medical dashboard” in guiding patients on a safe course to avoid heart attack, stroke, or premature death. For more information on the PLAC Test please visit www.plactest.com.

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Post from: Blisstree

Interview with Dr. Peter McCullough on the PLAC Test