High blood cholesterol is a major women's health issue. More than half of women over age 55 need to lower their blood cholesterol, and a quarter of all American women have blood cholesterol levels high enough to pose a serious risk for coronary heart disease.

Overall, an estimated 105 million American adults have total blood cholesterol levels of 200 milligrams per deciliter (mg/dL) and higher, which is above desirable levels. Of these, 42 million have levels of 240 mg/dL or higher, which is considered high risk. This is important because cholesterol levels are a contributing factor to heart disease, which develops over years.

But, don't fool yourself into thinking that high blood cholesterol is a problem only for middle-aged or elderly men and women. In fact, up to one-third of American children from age two through the teenage years, have high cholesterol, which can lead to heart disease in adulthood.

Guidelines released by the National Cholesterol Education Program (NCEP), a division of the National Heart, Lung and Blood Institute (NHLBI), in May 2001 and in July 2004, substantially expanded the number of American women and men warranting treatment for high cholesterol.

Based on mounting evidence that deaths from heart disease could be cut with aggressive treatment of high cholesterol, the NCEP guidelines spotlight elevated LDL or "bad" cholesterol. Elevated LDL cholesterol injures blood vessel walls and has been identified as a major cause of coronary heart disease.

 

Updated NCEP recommendations include:

• more aggressive cholesterol lowering treatment and better identification for those at risk for a heart attack
  
• use of a complete lipoprotein profile as the first test for high cholesterol
  
• a revised level at which low HDL cholesterol becomes a major heart disease risk factor
  
• a revised optimal level for LDL cholesterol for the population
  
• more aggressive treatment of high cholesterol for those with diabetes
  
• more intensive LDL cholesterol goals and treatment options for people at very high, high and moderately high risk for heart attack
  
• intensified use of nutrition, physical activity and weight control to treat elevated cholesterol levels. Medication may also be recommended for individuals at moderate to high or very high risk of developing heart disease, based on their cholesterol ranges. This integrated approach, called the "Therapeutic Lifestyle Changes (TLC) treatment plan," was introduced in the 2001 NCEP report, and remains a primary recommendation in subsequent updates.
  
• a sharper focus on a cluster of heart disease risk factors linked to insulin resistance, known as "the metabolic syndrome," which often occur together and dramatically increase the risk for coronary complications
  
• increased attention to the treatment of high triglycerides
  
• advisory against using menopausal hormone therapy (HT) to treat high cholesterol.