Cholesterol treatment

Statin treatment reduces the risk of cardiovascular disease in women

A large international study led by the CTC's Professor Tony Keech and Dr Jordan Fulcher has been published in The Lancet. It shows conclusively that statin treatment reduces the risk of cardiovascular disease in women.

In Australia more than 11,500 women die of a heart attack or stroke every year.

It has long been known that statin medications prevent heart attacks and strokes in people at risk.  Women tend to develop cardiovascular disease later in life than do men, so have been underrepresented in most statin trials.

The research assessed the effect of statins in 46,675 women and 127,474 men who had taken part in 27 clinical trials. It is the largest such database of statin trial data in the world.

Overall, statin treatment reduced the risk of a major vascular event (heart attack, stroke, need for coronary revascularisation stenting and bypass surgery, or cardiac death) by 21% for each 1 mmol/L reduction in LDL cholesterol achieved. The percentage risk reductions were similar in women and men, irrespective of any history of cardiovascular disease.

Such benefits from statin treatment translated into a significant reduction in the overall risk of death (9% risk reduction for each 1 mmol/L reduction in LDL-cholesterol) in both men and women.

Many women without a history of cardiovascular disease are at low risk of experiencing a major vascular event. This new analysis showed that even among the lowest risk group examined (less than 10% risk of such an event over 5 years), for every 1mmol/L LDL cholesterol reduction, 12 events would be avoided in men and 9 in women for every 1000 treated over five years, with the treatment benefits of statin therapy exceeding the known harms nearly 20-fold in both sexes.

There has been a recent worldwide shift towards recommending treatment with statins to people without existing cardiovascular disease but with a sufficiently high risk of future disease. The results of this study will reassure doctors that these risk-based guidelines for treatment can be applied to men and women equally.

The study was an international meta-analysis by the Cholesterol Treatment Trialists' Collaboration, an initiative of the Clinical Trials Centre and the Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, on behalf of academic researchers representing all major statin trials worldwide. The work is funded by the NHMRC, the UK Medical Research Council (MRC), the British Heart Foundation (BHF), and the European Community Biomed Program.

View the abstract here

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9 January 2015