Statins and Aspirin: Do They Really Work in Women?

Abstract

Cardiovascular disease continues to be the most common cause of mortality in women in the USA. As a result, greater emphasis has been placed on preventive measures. Studies examining the role of aspirin and HMG-CoA reductase inhibitors (statins) have shown important clinical differences in men versus women in the preventive realm. This has led to inconsistent recommendations by guideline committees and clinicians alike. This review presents a summary of the past and current guidelines. In addition, important clinical trials influencing current era practice are also discussed. Both strengths and limitations of these studies are described in detail, along with recommendations regarding future directions and the scope of aspirin and statin use for primary and secondary prevention of cardiovascular disease.

Statin prescribing according to gender, age and indication: what about the benefit–risk balance?

“…Further, it has even been questioned whether lipid-lowering guidelines are truly evidence-based [10,11]. The key issues in the debate are the appropriateness of statin prescribing for individuals with neither CVD nor diabetes, particularly women [12][13][14][15], and prescribing for older persons [9,16,17].…”

“…However, the beneficial effect of statins for individuals with chronic kidney disease and heart failure has been questioned [25,26]. While women and older people tend to be under-represented in RCTs, meta-analyses and literature reviews report conflicting results regarding the beneficial effect of statins in primary prevention -particularly in women [12,[21][22][23][27][28][29], as well as on the beneficial effect in older people in general [16,17,30]. As adverse effects such as muscle problems are particularly common among women and older persons [31], the benefit-risk balance most likely varies according to indication, gender and age.…”