{"id":29947,"date":"2012-06-25T16:05:51","date_gmt":"2012-06-25T20:05:51","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=29947"},"modified":"2012-06-25T16:05:51","modified_gmt":"2012-06-25T20:05:51","slug":"are-statins-equally-effective-in-women-and-in-men","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/06\/25\/are-statins-equally-effective-in-women-and-in-men\/","title":{"rendered":"Are Statins Equally Effective in Women and in Men?"},"content":{"rendered":"<p>Jose Gutierrez and colleagues performed a sex-based meta-analysis, seeking to determine if statins yield a similar protective effect on both men and women in preventing recurrent cardiovascular events. In <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1195535\">a paper published in the <em>Archives of Internal Medicine<\/em><\/a>, they report the results of their meta-analysis of 11 secondary prevention, double-blinded, placebo-controlled trials, which included 43, 193 patients (11,229 women and 31,962 men).<\/p>\n<p>Overall, statin therapy was associated with a significant reduction in overall CV outcomes for both men and women. For all-cause mortality and stroke, however, the benefit in women did not achieve statistical significance.<\/p>\n<p>All CV outcomes:<\/p>\n<ul>\n<li>women: RR 0.81, CI 0.74-0.89<\/li>\n<li>men: RR 0.82, CI 0.78- 0.85]<\/li>\n<\/ul>\n<p>All-cause mortality:<\/p>\n<ul>\n<li>women:\u00a0RR 0.92, CI 0.76-1.13<\/li>\n<li>men: RR 0.79, CI 0.72-.87<\/li>\n<\/ul>\n<p>Stroke:<\/p>\n<ul>\n<li>women: RR 0.92, CI 0.76-1.10<\/li>\n<li>men: RR 0.81, CI 0.72-0.92<\/li>\n<\/ul>\n<p>The smaller sample size of women is one possible explanation for the lack of a significant difference in mortality and stroke, according to the authors. Other factors &#8212; including the worse cardiovascular profile of women and lower use of antiplatelet agents in women &#8212; might also play a role, they speculate.<\/p>\n<p>In an <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1195515\">invited commentary<\/a>, Fiona Taylor and Shah Ebrahim write that it is &#8220;misleading&#8221; to focus on the lack of statistical significance in women. &#8220;The real issue is not significance but whether the effect size in women is materially different from the effect size in men,&#8221; they write, and note that &#8220;the effect on stroke and all-cause mortality in women is consistent with the effect in men.&#8221; They conclude that &#8220;statins work just as well in women as in men.&#8221;<\/p>\n<p>In an <a href=\"http:\/\/archinte.jamanetwork.com\/article.aspx?articleid=1195510\">editor&#8217;s note<\/a>, Rita Redberg states that we should not &#8220;assume women are the same as men.&#8221; She writes that &#8220;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.&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Jose Gutierrez and colleagues performed a sex-based meta-analysis, seeking to determine if statins yield a similar protective effect on both men and women in preventing recurrent cardiovascular events. In a paper published in the Archives of Internal Medicine, they report the results of their meta-analysis of 11 secondary prevention, double-blinded, placebo-controlled trials, which included 43, [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[961,584,698],"class_list":["post-29947","post","type-post","status-publish","format-standard","hentry","category-prevention","tag-secondary-prevention","tag-statins","tag-women"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29947","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=29947"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/29947\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=29947"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=29947"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=29947"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}