By Sally Robertson
The benefit of using statins may differ according to gender, show findings from a meta-analysis.
Although the therapy protects against the recurrence of cardiovascular (CV) events in both men and women, it only appears to reduce risk for all-cause mortality and stroke among men, report Jose Gutierrez (Columbia University, New York, USA) and colleagues.
"Increased awareness of this disparity is needed, and public policies addressing sex-specific differences in cardiovascular health are encouraged," writes the team in the Archives of Internal Medicine.
The between-gender differences observed here are likely to be due to the small proportion of women included in the trials (20.6%) and a worse cardiovascular health status in these same women, explains the team.
However, "the results still add to the cumulative evidence that women are undertreated for cardiovascular disease," write the researchers. "They also underscore the low rate of women being enrolled in cardiovascular prevention trials."
In an analysis of randomized trials representing a total of 43,193 patients, statins were more effective overall than placebo in preventing the recurrence of CV events, at a relative risk of 0.81. And the direction or significance of this risk reduction was not altered by gender stratification.
Likewise, statins were also better than placebo at reducing all-cause mortality and stroke, at relative risks of 0.81 and 0.84.
However, on stratification by gender, the protective effect against all-cause mortality and stroke did not reach significance for women, and only did so for men.
The team notes that the women did have an overall greater prevalence of hypertension and were older than men in most of the trials. "These differences conferred a somehow worse cardiovascular profile in studied women than in studied men."
In an editorial note, Rita Redberg (University of California, San Francisco, USA) asks: "Are the benefits of statins less in women and risks greater than men, or are there just not enough women in the clinical trials to demonstrate benefit in women[?]."
"Unless we increase inclusion of women in clinical trials and report sex-specific data, there will never be sufficient data to achieve optimal care of all of our patients," she adds.
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