By WP Creative Group

March 14, 2024

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High LDL (“bad”) cholesterol is often overlooked among women, leading to serious health implications.¹ Women are fighting back with advocacy and information.

The advice Latrice Baxter received from her doctor for her high cholesterol? Drink hibiscus tea. Five years later she was taken to the hospital in an ambulance for double bypass open-heart surgery.

The natural remedy recommendation from her doctor was not an evidence-based solution for Baxter, especially given her family’s history with heart disease. Recounting the experience at a recent Washington Post Live event, Baxter, a patient advocate and paid spokesperson for Amgen, couldn’t help but let out a bitter laugh at the prospect of drinking tea while a major blockage in her left main artery restricted the blood flowing from her heart.

“It’s funny in a not-so-funny kind of way,” Baxter said. “Back then I didn’t think much about it, but now, I see how concerning that is.”

Imbalanced risks, unequal treatment

Baxter’s experience as a woman of color is unfortunately not unique. Women with cardiovascular disease are less likely than men to be treated with cholesterol-lowering medications, and guideline-recommended, cholesterol-lowering therapy is more often prescribed for individuals who are white, have a high income or have advanced education.^[1],[2],[3]

Cholesterol-lowering therapy is a key intervention for individuals like Baxter who have high low-density lipoprotein (LDL) cholesterol, commonly known as “bad” cholesterol. When high LDL cholesterol isn’t treated properly, fatty deposits can build up inside arteries and reduce blood flow, increasing the risk of heart attack or stroke.^[4]

Baxter’s inadequate diagnosis and treatment were the catalytic events that eventually led to her time on stage at Washington Post Live: High LDL cholesterol among women is under-recognized, underdiagnosed and undertreated across the country.^[5] Four years after her surgery and almost ten after the insufficient tea advice, the issue is still prevalent nationwide and increasingly urgent.

An inadequate response to a runaway health crisis

Nearly 48 million women in the United States are affected by cardiovascular disease and every 40 seconds someone in the United States has a heart attack or stroke.^[6],[7]

These numbers have made cardiovascular disease — an umbrella term for health issues that impact your heart’s ability to function properly — a nationwide public health crisis. While some progress has been made in combating the epidemic, there are still significant gaps in awareness and treatment^[8] that leave people like Baxter at high risk for a health emergency.

One of the biggest risk factors for cardiovascular disease is high LDL cholesterol, but many patients receive generalized cholesterol lowering advice, regardless of the severity of their cholesterol level.

Proper nutrition and exercise play an important role in overall heart health and the majority of patients will be told to make changes to their diet and increase their level of physical activity.^[9] As a general rule, people at high risk of cardiovascular disease are advised to exercise at least 30 minutes a day, five times a week.^[10] However, depending on the person, their LDL level before treatment, and their family history, these types of lifestyle changes may not lower their LDL cholesterol enough to achieve recommended guidelines. What’s more, this inadequate reduction is especially observed in women and Black and Asian individuals.^[11]

To achieve recommended levels, the proper medication is often essential. Statins — a class of drugs that lower blood cholesterol like LDL — are often a good starting point.^[12] But even with a statin prescription, many people like Baxter are turning to additional non-statin therapies to achieve their necessary results.

“You leave the doctor after heart surgery with a big stack of prescriptions,” Baxter said. “But luckily, now I only have to take a few things: blood pressure medication, a blood thinner and I started on a statin therapy, but my doctor and I [saw] that my LDL cholesterol levels weren’t coming down very well so he put me on non-statin therapy, and I’m having a lot of success with that.”

Coming together to right past and current wrongs

For American women, the inequality in health care is deeply concerning. The symptoms, care and risk factors for cardiovascular disease can vary significantly between men and women,^[5] and women have many different comorbidities than men, including autoimmune disorders and even certain pregnancy complications.^[13]

Despite the differences in treatment and symptom presentation, it’s clear the system is set up primarily to cater to men. Women are underrepresented in drug trials and women under the age of 55, women of color and pregnant women are especially underrepresented.^[14] What’s more, only 15 percent of current cardiologists are women and over the past 20 years, the number of women entering cardiac medicine has only increased by one percent.^[15]

These stark inequalities led a group of women to create an organization that helps other women living with cardiovascular disease, WomenHeart. Three women who had suffered heart attacks in their forties decided to come together to address the inequality in care and provide information and services to women with similar experiences.

Celina Gorre, WomenHeart’s CEO, was on stage with Baxter at the Washington Post Live event to emphasize the broader community of women facing these challenges. “We see in our WomenHeart community that when [women] realize they can be empowered to advocate for themselves, they can hold their health care providers accountable so that they can get the care they deserve, and that we all deserve,” Gorre said.    

Organizations like WomenHeart and conversations like the ones held at this Washington Post Live are part of a broader national movement to raise awareness, improve communication and information, and ultimately impact care for women across the country. It’s clear that without significant changes in our current system, millions more women will suffer needlessly.

While Baxter didn’t initially receive the care she needed, she’s grateful now that she’s found a treatment and lifestyle balance that suits her and her health. Not only is she thriving personally, she’s begun to use her platform as a cardiovascular disease fighter and advocate for others navigating the same journey.

Her work as an advocate and champion for women’s health caught Gorre’s eye and the attention of WomenHeart, who took the opportunity at Washington Post Live to invite Baxter to become a WomenHeart Champion. “WomenHeart Champions are women with heart disease who are fierce advocates for themselves and for others,” Gorre said. “They take their messages far and wide, including to Capitol Hill, where they were just two weeks ago, advocating for policies to improve the heart health of women just like you and me.”

With greater awareness and information, the hope for Baxter and organizations like WomenHeart is that women will be empowered to demand the level of care they deserve. For Baxter, that’s the enduring message she wished more women understood. “My one wish would be that women understand that if you’re not getting what you need from your health care team, then just be aware that you can change,” Baxter said. “You don’t have to be stuck with someone who won’t take you seriously. It’s that important.”

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Managing your cardiovascular health starts with always knowing your current LDL (“bad”) cholesterol levels, which can be determined with one simple test. If you’d like to learn more about a free cholesterol testing program, visit whatismyldl.com. Terms and conditions apply.