Statins given to female patients are as effective in preventing the occurrence of cardiovascular events as they are for men, researchers from Boston and New York reported in the Journal of the American College of Cardiology. Cardiovascular events include stroke, heart attack, and angina.

William J. Kostis, Ph.D., M.D., from Harvard Medical School, and team set out to determine what impact statins might have on reducing cardiovascular event risk in male and female patients. They gathered and analyzed data on 18 clinical trials which had gender-specific outcomes. A total of 141,235 patients were involved in all the studies, of which 40,275 were female – there were a total of 21,468 cardiovascular events.

They found that those who were prescribed (randomly) statins had a considerably lower risk of a cardiovascular event compared to those on a placebo, usual care, or low-dose statin therapy. Females Odds Ratio were similar to men’s – Odds Ratio: 0.81, 95% CI: 0.75 to 0.89; p < 0.0001, and Odds Ratio: 0.77, 95% CI: 0.71 to 0.83, p < 0.0001, respectively. The authors explained that the benefits of statins, regardless of the baseline risk, or type of control, were similar for males and females. All cause mortality was also considerably lower for both the male and female patients who were on statin therapy. In the same journal, the authors concluded in an Abstract:

“Statin therapy is associated with significant decreases in cardiovascular events and in all-cause mortality in women and men. Statin therapy should be used in appropriate patients without regard to sex.”

Statins, also known as HMG-CoA reductase inhibitors, belong to a class of medications that are commonly prescribed to reduce cholesterol levels. They can block the chemical action that occurs in the liver for making cholesterol.

Our bodies need cholesterol in order to function properly. However, very high levels can raise the risk of developing atherosclerosis – cholesterol-containing plaques accumulate in the arteries and undermine blood flow. Statins can reduce cholesterol levels, and consequently lower the chances of developing angina (chest pain), stroke and heart attack.

Examples of statins include:

  • atorvastatin (the most potent, along with rosuvastatin)
  • cerivastatin
  • fluvastatin (the least potent)
  • lovastatin
  • mevastatin
  • pitavastatin
  • pravastatin
  • rosuvastatin (the most potent, along with atorvastatin)
  • simvastatin

Statins inhibit HMG-CoA reductase, an enzyme which controls the production of cholesterol in the liver. Statins act to replace the HMG-CoA in the liver, thus slowing down the process of cholesterol production. Liver enzymes sense that cholesterol production has gone down and create a protein which triggers the production of low density lipoprotein (LDL, or bad cholesterol) receptors, which relocate to the liver cell membranes – in short, the LDL is eventually taken into the liver and digested.

Statins may be prescribed for patients with atherosclerosis, some types of heart diseases, diabetes, and those with a family history of heart attacks, among others.

Although statins are prescribed mainly for those with high cholesterol levels, they may also be used to lower the risk of heart diseases by preventing atherosclerosis. Even though heart attacks can occur in patients whose blood cholesterol levels are not high, in the majority of cases heart attacks start with atherosclerosis plaque accumulation. Plaques resulting from atherosclerosis can form even when blood cholesterol levels are not high. Therefore, statins may be prescribed to treat patients whose blood cholesterol is not high, but have a higher risk of atherosclerosis (or have atherosclerosis).

Written by Christian Nordqvist