Statins for the goose and the gander

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When it comes to treating high cholesterol and its consequences, it seems that statins don t discriminate by gender even though men have a much higher rate of cardiovascular disease. According to a meta-analysis of over 141,000 patients, published in the Journal of the American College of Cardiology, statins reduced major cardiovascular events by 19 percent in females and 23 percent in males. After an average follow-up period of four years, researchers from Massachusetts General Hospital also discovered that, compared to the control arm, statin therapy lowered LDL (bad) cholesterol by over 25 percent in both men and women, and reduced the risk of stroke and coronary heart disease.

In addition, all-cause mortality decreased in female and male statin users by 10 percent and 16 percent, respectively. This led the researchers to conclude that statin therapy should be used in appropriate patients without regard to sex.

However, the study results can t be regarded as entirely conclusive. As Dr. Lori Mosca of Columbia University Medical Center points out, the studies included in the analysis had a limited number of trials that investigated the efficacy of statins in terms of primary prevention (that is, testing the drugs in people who had not had a previous cardiac episode). In addition, Dr. Mosca says, results should be provided for relative and absolute benefits, adverse outcomes, and cost-effectiveness. ACSH's Dr. Gilbert Ross agrees that this large study is not definitive, but he points out that the evidence of statins efficacy in reducing subsequent events secondary prevention is strong. He acknowledges, however, that the data on primary prevention is not as compelling, especially among women. While I wish that the researchers had parsed the data to differentiate between primary and secondary prevention trials, Dr. Ross notes, the risks associated with statin therapy are quite small, so I was glad to see the benefits accrued to both sexes almost equally.