Breast cancer gets the lion’s share of attention when it comes to women’s health, but heart disease is actually the leading cause of death among women. And with the American Heart Association’s new numbers for blood pressure rates, more women than ever are facing the realities of managing high blood pressure.

So what does all this mean for women 50 and better?

You are in the best, most vibrant years of your life. Keep all your glorious years – and keep your years glorious – by being pro-active about your health.

Let’s talk about cholesterol

The American Heart Association recommends that adults have a cholesterol screening every four to six years after age 20. Those who have already been diagnosed with high cholesterol or who have other risk factors for heart disease may need to get tested much more frequently, perhaps as often as every six months.*

Those “risk factors” include a family history of heart disease, smoking, not exercising regularly, being overweight, and… being post-menopausal. Truth is, we may consider heart disease a “men’s problem,” but 10 years after menopause, a woman’s risk of heart disease equals that of a man’s of the same age.

Cholesterol and menopause

What happened to my heart health? Estrogen may provide natural protection against heart disease by keeping blood vessels within the artery wall flexible, allowing blood to flow easily. After menopause, some of that protection is lost: blood pressure and LDL (bad) cholesterol rise, while HDL (good) cholesterol declines or remains the same. Fats in the blood called triglycerides also increase, potentially restricting blood flow.

I feel great. Do I need to get a cholesterol screening?

Yes. High cholesterol doesn’t generally have symptoms, so your levels could be high without you knowing it. The only way to tell if your levels are unhealthily high may be with a blood test known as a lipid profile or lipid panel. Cholesterol tests take four measures:

1. Total cholesterol. Just what it sounds like, this is a measure of all the cholesterol in your blood.
2. High-density lipoprotein (HDL). Often called the “good” cholesterol, HDL carries away the bad stuff from your blood, reducing the chance of obstruction. You want HDL levels at 40 to 60 milligrams per deciliter (mg/dL).
3. Low-density lipoprotein (LDL). This is the “bad” stuff that can cause fatty deposits to build up in your arteries, increasing the risk of heart attack or stroke. Preferred levels for LDL come in at less than 100 mg/dL.
4. Triglycerides. These fats in your blood can cause blockages. The FDA recommends this level stay under 150 mg/dL.

A single blood draw can generally test all your levels, though for a full panel workup, you may be asked to fast for 9 to 12 hours before the test is done.

Is there an easier way?

While getting a bit of blood drawn twice a decade probably doesn’t sound too arduous, for those who should or want to test their cholesterol levels more often, there are several at-home tests available.

Before you start down the DIY path, get your levels checked by a doctor so you know if you need immediate intervention or just frequent testing (or if you can wait 4-6 years), and to establish a baseline. Since not all the tests measure all the levels, your doc can also help you decide what levels need regular testing, if any.

As you might imagine, there’s variation in the types of tests, costs, and accuracy of results, so you’ll want to do your research.

Some things to consider when choosing your at-home cholesterol screening kit:

1. Which levels do you need to measure? Not every test takes all four measures, so know what you need.
2. How difficult is it to determine the results? Some test results have you compare color on a test strip to a color chart; some may find these difficult to read accurately. Others use an electronic meter similar to a glucose meter, which is less subjective.
3. Do you want immediate results, or are you okay with waiting for the samples to be sent to a lab and read by professionals? Waiting may yield the highest level of accuracy.
4. How complicated is it to take the test? There are a lot of directions, and making a mistake can yield an incorrect result. Fasting correctly, getting enough blood (don’t squeeze!), reading the result at the right time, kit storage, impatience with instructions… when it comes to your health, it’s important to do it right, so find a test that’s manageable.
5. How frequently do you want or need to be tested? While the kits with electronic meters are more expensive, if you plan on testing regularly, it might be worth the investment for increased accuracy.
6. Has the test been approved by the FDA? Some home cholesterol tests have the FDA seal of approval – check the packaging or call the manufacturer directly and ask.

While the tests themselves may be fairly accurate, if the test instructions are hard to follow or the results are hard to read, you can end up with incorrect information. And ultimately, cholesterol is just one piece of the heart-health puzzle: genetics, gender, diet, exercise, stress levels, age, nicotine use, medications, all sorts of factors are involved, so these tests are never a replacement for a doctor’s advice and oversight.

Finally, a regular cholesterol screening is great, whether done at a doc’s or in your dining room. While there’s not much we can do about our genetic lottery or the poor decisions of our youth, there are things women over 50 can do to decrease risk: healthy diet, not smoking, regular exercise, weight management, stress relief. Here’s to your healthy heart!

*The information in this article is for education only and should never replace treatment by a health care professional.