Mayo Clinic Women's HealthSource - October 16, 2001

Tuesday, October 16, 2001

New Cholesterol Guidelines

SCOTTSDALE, Ariz. - If, at last count, your level of HDL (good) cholesterol was 35 milligrams per deciliter (mg/dL), you probably were told that it was fine. Well, you may hear a different story the next time you visit your doctor. According to the October issue of Mayo Clinic Women's HealthSource, the National Cholesterol Education Program has issued new guidelines for cholesterol testing and control for the first time since 1993.

For women, these new guidelines have interesting ramifications. Until recently, it was believed that the estrogen in hormone replacement therapy (HRT) offered protection from heart disease, but recent research has questioned that belief. Now these new guidelines recommend cholesterol-lowering drugs instead of HRT for women at risk for coronary artery disease (CAD).

The updated guidelines recommend:

• From age 20 on, have a fasting lipoprotein test every five years to check levels of HDL, LDL (bad), and triglycerides.
• People at the highest risk for CAD are those with other artery clogging diseases or those with multiple risk factors such as obesity, smoking, high blood pressure or family history of CAD. These people should be tested more frequently and followed more closely.
• People with diabetes are considered to have the same risk as those with pre-existing CAD. The guidelines recommend more aggressive cholesterol-lowering treatment for people with diabetes.
• Lifestyle approaches to prevention are best. An appropriate weight, regular exercise, a balanced diet and not smoking are best, along with an increased use of statin drugs, which lower cholesterol.

Women, who typically develop CAD 10 to 15 years later than men, tend to think of CAD as a man's problem. Not true. Talk to your doctor to assess your personal risk factors and determine whether you would benefit from cholesterol-lowering medications.

A Primer on Anxiety Disorders

SCOTTSDALE, Ariz. - Everyone has anxiety now and again. Worry about a loved one or anxiety resulting from a disagreement is perfectly natural. In fact, anxiety is part of the survival instinct that helps us react to real danger. But the October issue of Mayo Clinic Women's HealthSource reports that you can suffer from too much anxiety. A variety of anxiety disorders affect about 25 million Americans.

You may suspect that you have an anxiety disorder if your fears center on events that are unlikely to happen or if your worries consume your thoughts. They also can develop in the wake of a fearful event. Don't think you're just having a small case of nerves. An anxiety disorder can be a serious illness. Below is a rundown of some of the different types of anxiety disorders.

• You may have generalized anxiety disorder (GAD) if you have full-time, persistent worry, or if you always fear the worst will happen. GAD affects about four million people in this country between the ages of 18 and 54. Signs include trouble sleeping, waking up feeling "wired", headaches, edginess, irritability and sweaty palms.
• Panic disorder is a feeling of terror that strikes suddenly and repeatedly without warning. Attacks can happen anywhere, anytime, even while sleeping. They are accompanied by intense physical symptoms like chest pain, shortness of breath or dizziness. Symptoms can be so severe you may feel you are having a heart attack, dying or losing your sanity. It is important to get help for this disorder because it is often associated with agoraphobia, a fear of leaving the house. -more-
• The term "phobia" covers a wide range of persistent, irrational fears of particular objects or situations. Fear of enclosed spaces, heights, water or flying are all examples. It is one thing to feel some discomfort about certain objects or situations, but when the fear is uncontrollable or affects your social interactions and daily functions, you may have a phobia.
• Post-traumatic stress disorder is a form of anxiety triggered by memories of a past trauma that you experienced or witnessed. You may have flashbacks, nightmares, hallucinations or severe distress, or you may feel a sense of detachment from the world or an inability to feel love.

  Anxiety disorders are the most common of all mental disorders, and yet many people never seek help. There are many medications and psychotherapeutic approaches that can successfully treat anxiety. If you think you may have one of the disorders listed above, you owe it to yourself to get evaluation and treatment.

  Coping With Hearing Loss

  SCOTTSDALE, Ariz. - According to the October issue of Mayo Clinic Women's HealthSource, one-third of U.S. adults over the age of 65 - and half of those over 75 - are hearing impaired. That means that as you age, you have a pretty good chance of losing some or all of your hearing. The good news is that there are many strategies to help you regain some hearing and listen in on your world.

  Once your inner ear is damaged, there is no way to fix it. So prevention is the best remedy. Take precautions by avoiding prolonged exposure to loud noises. For instance, wear earplugs or earmuffs when you mow the lawn or if you work in a very noisy environment. Early detection also can help prevent further hearing loss.

  Hearing aids may not be for everyone, but technological advances and alternatives may make them worth a try. Hearing aids are small amplifiers that help to stimulate hearing nerve cells. Digital hearing aids offer a greater ability to fine-tune sound without distortion.

  Some things you can do to maximize your hearing include letting friends and family know about your hearing loss, taking a lip-reading class and avoiding noisy situations like crowded restaurants. A 1999 National Council on Aging study found that people who didn't seek treatment for hearing loss were more likely to be depressed than those who wore hearing aids. If you've lost some hearing, consider these treatments. They can improve your hearing as well as your quality of life.

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