Lipid-lowering therapy with statins appears to reduce the risk of coronary events in women, although women remain undertreated and underrepresented in clinical trials.
Does lipid-lowering therapy reduce coronary events in women?
While evidence supports the use of statins to reduce coronary events in women, significant gaps remain in trial representation and clinical treatment rates.
Coronary heart disease (CHD) remains the leading cause of death among American women. Numerous differences exist between younger and older women and between women and men with respect to the pathology of CHD and its incidence and prevalence over the life cycle. Differences in lipoprotein levels and lipid fractions play an important role in CHD risk. Hormonal influences on lipoprotein levels in women are complex, change throughout the life span, and are influenced by the administration of oral contraceptives and hormone replacement therapy. Women with obesity, metabolic syndrome, or diabetes have lipid profiles that adversely affect CHD risk. To date, no randomized trials testing the impact of lifestyle changes on lipoprotein levels and subsequent CHD events in non-institutionalized women have been performed, and women have not been well represented in clinical end point trials of pharmacologic lipid-lowering therapy. Available evidence suggests that lipid-lowering therapy with statins does provide benefit in reducing the risk of coronary events in women; however, women remain undertreated, and more data are needed to determine optimal cardiovascular prevention and treatment in this population.
Vera Bittner (Tue,) conducted a review in Dyslipidemia and Coronary Heart Disease. Lipid-lowering therapy (statins) was evaluated. Lipid-lowering therapy with statins appears to reduce the risk of coronary events in women, although women remain undertreated and underrepresented in clinical trials.
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