Elevated levels >or= 60 mg/dL) of high-density lipoprotein cholesterol have been felt to be protective for cardiovascular disease in women. While cardiovascular disease is the leading killer of women in the United States, this is underrecognized, and women's symptoms are often atypical, leading to underdiagnosis. When high-density lipoprotein cholesterol is high, physicians may underestimate a woman's cardiovascular risk. This tendency may have adverse health consequences.