Written by Edward Edelson
Updated on July 11, 2002
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THURSDAY, July 11, 2002 (HealthDayNews) -- All women, even young women, should know their blood cholesterol level.
If they don't know, they'd better find out because a new analysis of data on more than 24,000 women shows a high blood cholesterol reading, stereotypically regarded as a problem primarily for middle-aged and older men, is a major risk factor for stroke in women in their 50s and even younger.
"Is it a shocking surprise?" asks Dr. Rose Marie Robertson, past president of the American Heart Association. "No, but it is a significant finding. This is the first study to really look at this issue in terms of cholesterol level and stroke mortality."
The information, appearing in the July issue of Stroke, comes from the Women's Pooling Project, which lumps together findings of eight large, long-term studies that included 24,343 women aged 30 to 97, with an average age of 52. In the course of a follow-up period as long as 20 years for some women, there were 568 deaths from stroke -- 10 percent of all deaths.
A group led by Dr. Lori Mosca, an associate professor of medicine at Columbia University, related the risk of death by stroke to the cholesterol levels and ages of the women. There was a clear relationship between deaths from ischemic stroke -- the kind that happens when a clot blocks an artery -- and blood cholesterol levels in women who were under 55 when they enrolled in a study. More than 80 percent of the fatal strokes were ischemic. No such relationship was found for older women or for hemorrhagic stroke, which occurs when a blood vessel bursts.
The risk was especially high for young black women. The risk was 76 percent higher than for white women in the younger group and 48 percent higher than for older black women. The relationship with cholesterol levels again was striking. Young black women with the highest readings were more than twice as likely to die of stroke than those with the lowest levels. That difference was not affected by other known risk factors, such as high blood pressure, smoking, diabetes and obesity.
In one sense, the report reaffirms what is already known. High cholesterol was cited as a stroke risk factor in an American Heart Association scientific statement issued last year. What the report adds is the emphasis on the dangers for women.
The results of the study are really significant in that regard, says a statement by Mosca: "Most prior research has had too few women, especially minority women, to firmly establish the relationship between cholesterol and stroke mortality."
The finding "suggests that women with elevated cholesterol, even in their 30s and 40s, should be aware of the increased risk of fatal stroke and whether they need to control cholesterol levels with therapy, in addition to lifestyle changes," Mosca says. Ways to reduce cholesterol levels include exercise and smoking cessation, she adds.
In practical terms, says Robertson, who is a professor of medicine at Vanderbilt University, the message is simple: "Patients and physicians should know that we need to do more screening, particularly in young people."
In general, she says, every woman -- like every man -- should have a blood cholesterol reading every year; for young people with no known risk factors, that interval might be every two years. However, for people with other risk factors, such as high blood pressure, diabetes, a smoking habit or a family history of stroke, the interval between checkups could be shorter.
If the reading for LDL cholesterol, the "bad" kind that clogs arteries, is at the danger level, 130 or higher, the doctor should be asked about a course of action. Many people can keep cholesterol under control by eating properly, Robertson says. Those who can't might be prescribed a statin, one of the family of cholesterol-lowering drugs that have been shown to reduce the risk of stroke death.
What To Do
To learn all about cholesterol, go to the American Heart Association, while the National Institute of Neurological Disorders and Stroke has information on brain attacks.
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