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Women Benefit as Much as Men From Statins for Primary Prevention of CVD

Tuesday, March 09, 2010
Reviewed by Aaron A. Gelfand, MD, FACOG, Clinical Assistant Professor, University of Medicine and Dentistry of New Jersey, Newark, NJ
NCME TV™ Staff Editor: Devera Pine

Credits Available

Up to 0.25 AMA PRA Category 1 Credit™ through March 09, 2011

Estimated time to complete

15 minutes

Disclosures

Dr. Gelfand reports nothing to disclose.

The NCME TV Staff Editor reports nothing to disclose.

Medical News Alert

NEW YORK (Reuters Health) - Statin use by women cuts their risk of primary cardiovascular disease (CVD) events by roughly a third, which is similar to the risk reduction seen in men, research shows.

"Statin therapy in women without CVD is controversial, given the insufficient evidence of benefit," Dr. Samia Mora, from Brigham and Women's Hospital, Boston, and colleagues note in the March 9th issue of Circulation.

Dr. Mora and colleagues analyzed gender-specific outcomes from the randomized JUPITER trial and performed a meta-analysis of statin trials that focused on women.

JUPITER included 6801 women at least 60 years of age, and 11,001 men at least 50 years of age. All had high C-reactive protein levels (at least 2 mg/L) and normal to low levels of low density lipoprotein cholesterol (no higher than 130 mg/dL). Participants took either rosuvastatin or placebo daily. The meta-analysis included 7 primary prevention trials, with 13,154 women who had 240 CVD events and 216 deaths.

Compared to the men in the JUPITER trial, the women had lower absolute CVD rates per 100 person-years (0.57 vs. 0.88 for rosuvastatin groups and 1.04 vs. 1.54 for placebo groups) - but both genders had relative risk reductions of roughly 44%.

Further analysis showed that statin therapy significantly reduced revascularization and unstable angina in women, but did not affect other CVD events.

In the meta-analysis, statin use by women cut primary CVD events by 37% (p < 0.001), but did not significantly affect total mortality.

When the results of JUPITER and the meta-analysis are taken together, the researchers conclude, "statin therapy resulted in about a one-third relative reduction in primary CVD in women, a benefit similar to that seen in previous meta-analyses of men."

Circulation 2010;121:1069-1077.

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Learning Objectives

  • Stay current with and assess the potential clinical applications of daily medical news reports
  • Prepare for responding to patient inquiries about a daily medical news story in the lay press

Heart of the Matter™

  • Statin use by women cut the risk of primary CVD by about a third in this analysis of data from 6801 women in the JUPITER trial and from a meta-analysis of 7 primary prevention trials with 13,154 women
  • Statin use significantly reduced primary CVD events by 37% in women, but did not significantly affect total mortality. Statin therapy also significantly reduced revascularization and unstable angina in women
  • Statin therapy in women without CVD is controversial, given the insufficient evidence of benefit. In this study, the risk reduction in women was similar to that seen in men
  • Explain to women patients that although the use of statins in women without evident heart disease is still controversial, these studies suggest that the medicines can cut the risk of heart disease events by about a third

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