Women, Cholesterol, and Heart Attacks

QUESTION: Correct me if I am wrong, but since women are not as prone to heart
attacks as men, and since cholesterol is what causes heart attacks, then it
follows that controlling cholesterol in women is not as important as in men.
Do I have my facts straight?
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ANSWER: I suppose your letter might be classified as "A little knowledge may
be a dangerous thing" for in using facts that are half right to construct your
conclusion, you have come out just about all wrong. But we can straighten it
out together. You are right, women are less prone to heart attacks than men,
but only when you consider the statistics before menopause. Once the
protection that female hormones must afford is finished the picture changes
dramatically, and within 6 to 10 years after menopause the women have caught
up to the men and are suffering heart attacks at about the same rate. You are
right, elevated cholesterol is a factor in heart attack and cardiovascular
disease, but though very important is but one factor and can not be
considered as a direct 1 to 1 relationship. The fact is that the latest
report on the implications of cholesterol on health from the National
Cholesterol Education Program fails to draw any distinction between men and
women, and offers exactly the same guidelines about detection, evaluating and
treatment of high levels of blood cholesterol for both. Blood levels of above
200 mg/dL should be confirmed by a second or third test. If the findings are
over 240 mg/dL, a test for levels of low-density-lipoprotein cholesterol (LDL)
should be run, and its results used to guide the therapy. 160 mg/dL of LDL
and above is classified as high risk, between 130-159 mg/dL is considered
borderline. Appropriate therapy depends upon a variety of factors, but
includes diet as a first line defense followed, when indicated, by medication.