Women and Men Benefit Equally from Statin Therapy

January 30, 2015

Women and Men Benefit Equally from Statin Therapy

  1. Bruce Soloway, MD

At 1 year, cardiovascular-related adverse events and deaths were lowered similarly in both sexes.

  1. Bruce Soloway, MD

Statins safely lower the incidence of major adverse vascular events (i.e., nonfatal myocardial infarctions or coronary death, any stroke, and coronary revascularization) by about 20% for every 40 mg/dL reduction in LDL cholesterol, regardless of baseline cardiovascular risk. But women have been underrepresented in many statin trials, and meta-analyses based on aggregate data have lacked the statistical power to reliably compare the effectiveness of statins in women and men.

The 2012 patient-level meta-analysis (of 27 randomized trials of statin vs. control therapies or high- vs. low-dose statins that included >170,000 participants [27% women]; median follow-up, 4.9 years) that established the effectiveness of statins regardless of cardiovascular risk suggested that statins were equally effective in both sexes in all risk strata (NEJM JW Gen Med Jun 12 2012). The authors now revisit those data to describe the effects of statins in women and men in greater detail.

Statins had similar effects on lipid levels in women and men after 1 year of treatment. For each 40 mg/dL reduction in LDL cholesterol, women and men had comparable overall reductions in major vascular events (rate ratios, 0.84 and 0.78, respectively) and all-cause mortality (RRs, 0.91 and 0.90, respectively), with similar results in each stratum of cardiovascular risk. Statins were not associated with differences in cancer incidence or noncardiovascular-related mortality in either sex.

Comment — General Medicine

This analysis provides reassurance that recent risk-based guidelines on lipid management can be applied to both women and men with the expectation of equivalent benefits.

Comment — Cardiology

  1. JoAnne M. Foody, MD

These data reinforce the important role of statins in primary and secondary prevention. Regarding the ongoing debate in both the scientific and lay communities about the usefulness of statins in women, this analysis clearly refutes the claim that they benefit less than men from these lifesaving drugs. Clinicians should be clear about the value of statins in appropriately selected women.

Editor Disclosures at Time of Publication

  • Disclosures for Bruce Soloway, MD at time of publication Nothing to disclose


Reader Comments (1)

Carol A Vassar, MD Physician, Internal Medicine, private practice VT

The relative risk reduction is similar. And what is the absolute risk reduction?

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