Statins' effects on men and women compared

Statin therapy reduced women's risk of cardiovascular events but did not significantly affect mortality or stroke risks in a recent meta-analysis.

The meta-analysis included 11 randomized, double-blind trials with more than 40,000 patients in which statins were compared to placebo. Researchers calculated statin effects in women versus men. Compared to placebo, statin therapy was associated with a significantly reduced risk of cardiovascular events in both sexes (relative risk [RR], 0.81 [95% CI, 0.74 to 0.89] in women and 0.82 [95% CI, 0.78 to 0.85] in men).

However, women did not see the same benefit in the outcomes of all-cause mortality and stroke. Men on statins had a relative risk for mortality of 0.79 (95% CI, 0.72 to 0.87) compared to placebo, while statin-taking women's decrease in relative risk was insignificant at 0.92 (95% CI, 0.76 to 1.13). Also with stroke, men saw a significant benefit (RR, 0.81 [95% CI, 0.72 to 0.92]) and women didn't (RR, 0.92 [95% CI, 0.76 to 1.10]). Sensitivity analysis of the trials also suggested that lipophilic statins might be better for women than hydrophilic statins, meta-analysis authors concluded.

The authors also noted that women made up only 20% of the studies' population and they offered several possible explanations for their findings, including that women in the trials had worse cardiovascular profiles than men and were less likely to receive antiplatelet drugs. Overall, the analysis supports the use of statins in women for secondary prevention of cardiovascular events, they concluded.

A commentary that accompanied the analysis, in the June 25 Archives of Internal Medicine, criticized the research methods of the authors and pointed out that the confidence intervals for women's and men's outcomes overlapped. The commentary authors concluded that “statins work just as well in women as in men.” An editor's note about the analysis said that it was evidence of the need for greater inclusion of women in clinical trials and more reporting of sex-specific data.