• Ioanna Gouni-Berthold and Ulrich Laufs.
• Center for Endocrinology, Diabetes and Preventive Medicine, University Hospital Cologne, Faculty of Medicine and University of Cologne, Germany; Department of Cardiology, University Hospital Leipzig, Germany.
• Dtsch Arztebl Int. 2024 Jun 14; 121 (12): 401406401-406.

BackgroundCardiovascular diseases due to arteriosclerosis are the most common causes of death and disability in both men and women. Hypercholesterolemia, a treatable risk factor, is often detected after a delay in women, and then inadequately treated. It is, therefore, important to know the sex-specific aspects of cholesterol metabolism and to address them specifically.MethodsWe conducted a selective literature search in PubMed with particular attention to current guidelines.ResultsIn the population as a whole, the age-associated rise in serum cholesterol levels occurs approximately 10 years later in women than in men. Women are exposed to a higher cholesterol load than men at the beginning of their lives, and especially after menopause. This is correlated with a later, but nonetheless clinically relevant rise in the incidence of myocardial infarction in older women. Because women's LDL cholesterol and lipoprotein(a) levels rise after menopause, their lipid profiles should be re-evaluated at this time. Moreover, conditions that are specific to women such as polycystic ovary syndrome, contraception, and especially the phases of life-such as planning to become pregnant, pregnancy, and breastfeeding-need to be considered for both diagnostic and therapeutic purposes. Sex-specific differences and cholesterolassociated risks are particularly pronounced in women with familial hypercholesterolemia (prevalence 1:250).ConclusionLowering high cholesterol levels, especially in postmenopausal women, may prevent the development of cardiovascular diseases.

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