women and men

In women and men at an equivalent risk of cardiovascular disease, statin therapy is of similar effectiveness for the prevention of major vascular events

Background

Previous CTT meta-analyses had shown that statins reduce the risk of occlusive vascular events in a wide range of people, but there was debate as to whether statin therapy was as effective in women as in men. The CTT Collaboration conducted meta-analyses of combined data from large randomized controlled trials of statin therapy to address this uncertainty.

Methods

Individual participant data from 22 trials of statin therapy versus control (involving approximately 135,000 individuals) and 5 trials of more intensive versus less intensive statin therapy (involving approximately 40,000 individuals) were analyzed. Effects on major vascular events in women and men were compared.

Findings

• Women were generally at lower cardiovascular risk than were men in these trials.
• Allocation to a statin had similar absolute effects on 1 year lipid concentrations in both men and women (LDL cholesterol reduced by about 1·1 mmol/L in statin versus control trials and roughly 0·5 mmol/L for more-intensive versus less intensive therapy).
• The proportional reductions per 1·0 mmol/L reduction in LDL cholesterol in major vascular events were similar overall for women  and men, and were also similar for those women and men at less than 10% predicted 5 year absolute cardiovascular risk. Likewise, the proportional reductions in major coronary events, coronary revascularization, and stroke did not differ significantly by sex.