June 26 Cholesterol-lowering statin drugs are
just as effective for women as for men in preventing heart
problems in people who have already had a heart attack or
stroke, according to a U.S. study.
Although statins are widely used for so-called secondary
prevention - to stop repeat heart attacks and strokes - some
analyses have questioned whether they work as well in women as
in men, said Jose Gutierrez at Columbia University in New York,
who led the study.
Gutierrez and his colleagues consulted previous trials in
which both men and women at risk of a second heart attack or
stroke were randomly assigned to a statin or a drug-free placebo
pill. The studies included a combined 43,000 people and lasted
anywhere from four months to more than six years.
Writing in the Archives of Internal Medicine, the
researchers said that despite some lingering questions, their
analysis "supports the use of statins in women."
Overall, both men and women assigned to statins were 18 to
19 percent less likely to have one of a combination of any
cardiovascular problems, including heart attacks, strokes and
deaths related to heart disease.
For example, about seven percent of both men and women on
statins had a heart attack - either fatal or not - compared to
10 percent of participants on placebos.
Men taking statins also had a 19 percent lower risk of
strokes in particular and a 21 percent reduced chance of dying
from any cause than those in the placebo group.
The same trend held up in women, but the effect was smaller,
and the difference between the statin and placebo groups could
have been due to chance, they said.
Gutierrez and his colleagues noted that both men and women
had similar changes in their cholesterol while on the drugs,
including a 26-point drop in total cholesterol in the statin
group versus a three- to six-point difference among those taking
One limitation, the researchers noted, is that women only
made up about one-fifth of all participants in the studies
combined, so it's possible there just weren't enough of them to
show the same effect of statins on strokes and deaths that was
seen in men.
There are other possible explanations if women turn out to
really not get as much benefit from statins, such as the effect
of hormonal differences, Gutierrez said.
"Another explanation could be the health disparity in women,
and if they are sicker, probably we don't see as much benefit,"
he told Reuters Health.
Gutierrez also noted that women in the studies were less
likely to be taking aspirin and other potentially risk-reducing
medications than men.
And statins are the end-all, be-all for heart health.
"Despite statins, cardiovascular events continue occurring.
They still happen regardless of what we do," Gutierrez said.
"So maybe besides statins, we should also concentrate on
other factors that affect cardiovascular disease, such as
hypertension, diabetes and smoking cessation."
(Reporting from New York by Genevra Pittman at Reuters Health;
editing by Elaine Lies and Bob Tourtellotte)