Statins yields greater cardioprotection in women than men

Treatment with statins is effective at lowering cardiovascular disease risk, with the protective effect seemingly stronger in women than in men, according to a study. However, high-intensity regimens confer only minimal additional benefit in both sexes.

The study included 47,801 Dutch patients without prior cardiovascular disease who were seen at outpatient cardiology clinics. Of these 17,008 were statin users and 30,793 were nonusers. Statins were categorized as low-intensity and high-intensity according to Dutch guidelines.

Statin users were more likely to be older (62 vs 55 years), men (52 percent vs 43 percent), present with comorbidities such as hypertension (46 percent vs 23 percent) and dyslipidemia (39 percent vs 7 percent), and be prescribed cardiovascular medication other than statins at baseline (80 percent vs 34 percent).

Researchers used propensity scoring to match individuals prescribed statins at baseline and those eligible for statin therapy (low-density lipoprotein >2.5 mmol/L) without a statin prescription. Propensity-score matching resulted in a cohort that comprised 8,631 statin users and 8,631 nonusers who were highly similar on all baseline characteristics. Overall, 35 percent of women and 28 percent of men received a low-intensity statin.

Statins showed a stronger beneficial effect on both all-cause and cardiovascular mortality in women (hazard ratio [HR], 0.66, 95 percent confidence interval [CI], 0.58–0.74 and HR, 0.55, 95 percent CI, 0.39–0.71, respectively) than in men (HR, 0.89, 95 percent CI, 0.81–0.95 and HR, 0.93, 95 percent CI, 0.77–1.08, respectively).

Meanwhile, high-intensity statins yielded only modest protection against all-cause mortality (HR, 0.94, 95 percent CI, 0.88–1.00) and cardiovascular mortality (HR, 0.86, 95 percent CI, 0.74–0.98) in both men and women.

The present data indicate that statins seem to be effective for cardiovascular disease prevention, regardless of treatment intensity, especially in women.