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Life-Saving Cholesterol Medication May Be Underprescribed in Women

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WebMD Health News

Feb. 14, 2000 (Minneapolis) -- A new study shows that despite the fact that cholesterol-lowering medications can lower the risk of heart attacks and death in people with heart disease, many physicians at major teaching hospitals still do not prescribe them. The study, undertaken by researchers from several leading universities, also found that significantly fewer women than men with heart disease are receiving any medication at all. The study was published in the Feb. 14 issue of the Archives of Internal Medicine.

"In general, treatment rates for patients with a history of heart disease were far too low, but the lack of adequate treatment in women was particularly worrisome," writes lead author Michael Miller, MD, director of preventive cardiology at the University of Maryland Medical Center and colleagues from elsewhere. "These results provide evidence of considerable sex bias in the treatment of women with heart disease at major academic medical centers." Miller is also associate professor of medicine at the University of Maryland School of Medicine.

The study investigated the use of cholesterol-lowering medications in more than 800 men and women with heart disease at 16 academic medical centers in the U.S. and Canada. Twenty percent of the study participants were women. Researchers found that about half of the patients had dangerously high levels of LDL, the "bad" form of cholesterol, above 130 mg/dL.

 

According to the National Cholesterol Education Program guidelines, the LDL goal in heart disease patients should be below 100 mg/dL. Patients with an LDL that exceeds 130 mg/dL will generally require medication, as will people who continue to have an LDL greater than 100 mg/dL even after making dietary changes.  

Researchers found that in 1994, a little more than one-third of women and men with high LDL were receiving cholesterol-lowering medication. By 1997, however, more than half of the men were receiving medication, while only one-third of women were receiving drug therapy. Not surprising, scientists also learned that women were much less successful than men in reaching acceptable LDL levels.

Researchers did not know why women were so under-treated compared to men, especially since the extent of heart disease was similar in both groups.

"We have great knowledge and proven therapies to reduce the risk of first and second [heart attacks]," Miller tells WebMD. "We also have great [study results] to show that we can reduce the risk of heart disease. [Now,] we need to take better advantage of these [resources.]"

Other experts say that patients also need to take responsibility for their health. Dick Karas, MD, PhD, director of the Women's Heart Center at New England Medical Center in Boston, says it's important for patients to know their cholesterol levels and keep track of changes. "Ask your doctor what it is, and write it down," he tells WebMD.

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Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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