Women may not achieve same cardiovascular benefits from statins as men

A meta-analysis published in the journal Current Medical Research and Opinion suggests that women may not achieve the same cardiovascular (CV) benefits from statins as men.

CV disease is the leading cause of mortality among women in the United States, resulting in approximately 500,000 deaths annually.

The authors stated that the benefit of statins on cardiac events in women has not been fully established. Thus, the goal of their research was to attain adequate statistical power, by pooling results of randomized clinical trials, to assess the impact of statins on CV events for both men and women separately.

The study demonstrated that the risk of a patient having ≥1 of these CV events was significantly reduced with statin therapy in both men (RR=0.76; 95% CI, 0.70–0.81) and women (RR=0.79; 95% CI, 0.69–0.90). However, when the researchers analyzed each CV event separately, men had a statistically signif-icant decrease in myocardial infarction (RR=0.72; 95% CI, 0.64–0.81) and a trend towards reductions in mortality (RR=0.84; 95% CI, 0.69–1.02) and stroke (RR=0.91; 95% CI, 0.71–1.17). In comparison, women demonstrated only a trend towards a reduction in the risk of myocardial infarction (RR=0.89; 95% CI, 0.71–1.12) and did not have a reduced risk of mortality (RR=1.00; 95% CI, 0.85–1.18) or stroke (RR=1.14; 95% CI, 0.82–1.59).

The authors emphasized the importance of assessing differences in drug benefits with regard to gender and summed up the differences demonstrated in their research: "These data indicate that while the decrease in the combined end point of cardiovascular events in men appears to be driven by reductions in death, MI, and stroke, women do not have an appreciable decrease in stroke [or] overall mortality."The authors stated that the majority of benefits for women may include reductions in unstable angina and the need for revascularization.

"While it is encouraging to see that both men and women reduced their risks of developing a cardiovascular event by about one-third when they took statin therapy, it is discouraging to see that women on statins may not have reductions in mortality and stroke like their male counterparts," the authors stated.

The authors said that the lack of a statistically significant reduction in some of the cardiovascular end points is likely due to the small female population from which to evaluate these end points, rather than a lack of effect, but they said further studies are needed to support this idea.

SOURCE Dale KM, Coleman CI, Shah SA, Patel AA, Kluger J, White CM. Impact of gender on statin efficacy. Curr Med Res Opin. 2007;23:565–574.