Healthy Skepticism Library item: 8088

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Publication type: news

Genders differ in response to statins after heart attack: study
CBC News 2007 Jan 29
http://www.cbc.ca/health/story/2007/01/29/statins-gender.html

Full text:

Cholesterol-lowering statin drugs help reduce the risk of death after a heart attack, but men appear to benefit more than women, researchers in Quebec have found.

Statins are among the bestselling families of drugs, and are linked to fewer deaths among patients who have had heart attacks.

Since women are often underrepresented in clinical trials of the statins, researchers had not taken a close look at potential sex differences in the effectiveness of the drugs.

In their study, Dr. Louise Pilote of Royal Victoria Hospital in Montreal and her colleagues compared death rates among more than 14,000 users of statins and more than 23,000 non-users who were discharged from hospital after having a heart attack.

Use of statins after a heart attack lowered the risk of death more among men than among women, whether cardiac deaths or deaths from other causes were considered, the team reports in the Jan. 30 issue of the Canadian Medical Association Journal.

As for why, it may be that statins are processed differently in men and women, the researchers suggested.

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“If corroborated by independent studies on the effects of statins on serum cholesterol levels, these results would suggest a possible need for reappraisal of target daily doses for statins,” the team concluded.

“Women might require a higher dose to achieve preventive effects similar to those observed in men.”

Conclusions questioned
But the researchers’ interpretation exaggerates the benefits of statins, said Dr. Jim Wright, medical director of the Therapeutics Initiative at the University of British Columbia.

Wright questioned the idea that women may need a higher dose. Since women’s weight on average is lower than men’s, females would actually receive a higher concentration of the drug, said Wright, an internist and clinical pharmacologist who specializes in hypertension.

“I think the only plausible explanation [for the difference seen between men and women on statins] is that women are being harmed by the drugs and it’s leading to deaths that are presently unrecognized to be caused by the statins,” he said.

Nonetheless, the findings highlight how men and women respond differently to drugs and raises questions about why, Wright said.

The researchers used hospital and drug-claim databases to identify the patients, who were tracked for up to seven years.

The database did not include information on tobacco use and obesity, which may at least partly explain the differences, the researchers said.

With files from the Canadian Press