June 26 (Reuters) - 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 placebos.
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." SOURCE: bit.ly/MvIkUo (Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies and Bob Tourtellotte)