Statins May Work Better in Men Than in Women
Analysis Fails to Show Stroke Reduction, Survival Benefit in Women
June 25, 2012 -- Women with heart disease may not benefit as much as men with heart disease from taking cholesterol-lowering drugs, a new research analysis suggests.
The review of studies evaluating statins showed that there was a reduction in death in men but not in women. The study concludes that there is no benefit of statins on stroke and all causes of mortality in women.
However, like men, women who had previous cardiovascular disease such as a heart attack, angina, or stoke and took a statin had a lower risk for a second heart attack, so the drugs do have clear benefits for women with heart disease, researchers say.
Statins and Gender
The findings raise new questions about whether true differences exist between men and women in their response to cholesterol-lowering drugs.
Just one-fifth of the participants in the trials were women, and it could be that this was too small to show real benefits.
"I don't really think biological differences between the sexes make women less susceptible to the benefits of using statins," researcher Jose Gutierrez, MD, MPH, of Columbia University, tells WebMD. "But if we want a clear answer to this question it is critical that more women be included in clinical trials."
The analysis included 11 major studies involving more than 43,000 people.
The studies were designed to examine whether statin therapy lowers heart disease and stroke risk in people who have had a previous heart attack, stroke, or other heart-related event.
Fewer Deaths in Men Who Took Statins
Overall, statin use was associated with a similar reduction in recurrent heart attacks in men and women.
Among men, taking statins was associated with a decrease in strokes and death, but the difference was not seen in women.
The study appears in the June 25 issue of the journal Archives of Internal Medicine.
In an accompanying editorial, Fiona Taylor, PhD, and Shah Ebrahim, DM, of the London School of Hygiene and Tropical Medicine, point out that earlier reviews have shown at-risk women to benefit as much as men from the drugs.
They contend that the researchers failed to include relevant studies that would have shown a clear survival benefit associated with statin use in women with heart disease.
"We suggest that statins work just as well in women as in men," they conclude.
Risk, Benefits Unclear in Women
But cardiologist Rita F. Redberg, MD, says it is far from clear that this is the case, because so few women have been included in past clinical trials.
Redberg is director of Women's Cardiovascular Services at the University of California, San Francisco Medical Center, and she was an editor of the new study.
"Although there is a growing interest in personalized medicine, we still lack high-quality data on the largest group of patients in practice -- women," she wrote.