April 22, 2021 is the National Women's Health Day, dedicated to the prevention and treatment of the main female diseases, including hypercholesterolemia.
When one thinks of cardiovascular disease, one immediately thinks of the protection that estrogen hormones offer to women. It is always thought that men are at risk and women are not, given that there is this sort of hormonal "umbrella" designed to protect against all the elements that can occur to the arteries. Unfortunately, hormonal protection tends to decline over time and, with the end of fertile life, the female cardiovascular risk progressively approaches that of men. For this reason, risk factors such as excess cholesterol must be kept under control. And we must never forget the therapies indicated by the doctor if necessary. In fact, with therapeutic “holidays” we put our health at risk. How to behave then? And what can be the tools to increase adherence to treatment, which is fundamental in heart attack prevention and beyond? Here are the advice of Livia Pisciotta, Associate Professor of Dietary Sciences at the University of Genoa, expert in Lipidology, and referent of the Family Dyslipidemia Center of the San Martino Polyclinic.
How much does cholesterol "weigh" on women's health?
"The Italian data collected by the Istituto Superiore di Sanità in the period 2008-2012 show that about one in three people has a total cholesterolemia above 240 mg / dl (milligrams per deciliter), more precisely 34.5% of men and 36.5% of women ”explains the expert. If we consider total cholesterol values above 200 mg / dl, this situation is found in more than half of people, i.e. in 65% of men and 67% of women. In women, cholesterol tends to rise in the period of menopause: the average value of total cholesterol increased in the decade 2002-2012, going from 219 to 226 mg / dl, and this reflected on the prevalence of hypercholesterolemia, which rose from 36% to 51. % ". In short: menopause becomes a sort of "watershed" for the fair sex, which should not be underestimated. "Exactly so" resumes Pisciotta. "A hypercholesterolemic woman, with the same cholesterol levels, during the fertile age has a lower risk than a man of suffering a cardiovascular event. However, it has been observed that cardiovascular events in women, although numerically fewer, are clinically more severe. The often atypical clinical presentation that leads women to neglect symptoms and arrive late for treatment plays a role. From menopause onwards, the cardiovascular risk in women increases significantly until it exceeds the risk of males after 10-15 years ”. Also for this reason, keeping cholesterol under control must become a fundamental goal in the path of women's health.
Therapeutic adherence, a possible goal if the diet is not enough
Fortunately, there is some good news. The state of control of hypercholesterolemia in women has recently improved: adequately treated women have gone from 15.3% to 30.2% of the total hypercholesterolemia. "But on this front, adherence to treatment plays a primary role in reducing risk as intervention studies highlight significant long-term benefits and epidemiological data show that those who stop treatment lose the benefit of therapy" he continues the Pisciotta. "Women tend to be less adherent than men to lipid-lowering treatments, the reasons are not clear and there are many: however it is hypothesized that women are more inclined to underestimate their level of risk, to think of controlling their risk with only diet and that they are more attentive to the relational aspects with their doctor which they are sometimes dissatisfied with, not finding adequate answers to their fears related to therapies. Depression is another factor that can affect adherence. Another factor that plays a role in adherence is the presence of multiple risk factors that may make polypharmacy necessary. In this sense, combination therapies significantly contribute to increasing adherence rates because they reduce the number of daily intakes and are generally more effective, allowing maximum results with minimum effort. This can also have a good psychological impact ”. Final recommendations: if you have high cholesterol, carry on a path of lipid-lowering therapy without fear by relying on your doctor who now has safe and effective therapies without particular limitations of use. “The doctor, on the basis of the global risk, establishes the therapeutic objectives and personalizes the treatment, even in the event of any intolerances” concludes Pisciotta. "Most women can fully benefit from the first level of care and, if necessary, there are also second and third level therapies, some that can only be prescribed by specialists and reserved for very high-risk cases, which allow them to achieve the objectives cholesterol levels such as to guarantee real cardiovascular protection. Always remembering that a correct lifestyle is always recommended for everyone but does not always allow to reach the cholesterol goals appropriate to the risk ".
For information visit the website https://www.alcuoredelladerenza.it/
In collaboration with the Servier Group in Italy
Tag: Cholesterol Women