Q: I’m concerned about my risk for heart disease, but don’t know what blood tests I should keep my eye on. Can you explain how a woman’s blood fat levels might differ from a man’s?
– Erin in Dallas

A: If your cholesterol is above 200, most doctors say you should worry about heart disease. That is, unless you are a woman. The Lipid Research Clinics studied women between the ages of 50 and 69 years and found that high HDL-cholesterol (that’s the good stuff) was most protective against fatal heart attacks. In fact, women with HDL values less than 50mg/dl were more than three times more likely to die from heart disease than were women with higher HDL levels. On the other hand, total cholesterol values didn’t affect fatal heart disease when HDL was high. In essence, a high HDL “wipes out” any increased risk from high total cholesterol or LDL- cholesterol. A conflicting study investigated the risk for heart disease (not fatal heart attacks) in women and concluded that women who smoke and/or have high apo B levels (that’s the protein associated with LDL – high apo B means high LDL) are at highest risk for developing heart disease. Until further research irons out the discrepancies between these two studies, it is best for women to keep an eye on all their blood cholesterol levels. According to the National Cholesterol Education Program, people at lowest risk for heart disease have a total cholesterol below 200mg/dl, an LDL-cholesterol below 130mg/dl, and a ratio of total cholesterol to HDL- cholesterol under 4.5. Women at low risk should repeat the blood test every five years, while women with values greater than these should be checked annually or even more frequently. -Elizabeth Somer