Pharmacy Practice, Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, 1 University Plaza, Brooklyn, NY, 11201, USA.
NYU Langone Medical Center, New York, NY, USA.
Curr Atheroscler Rep. 2016 Feb;18(2):6. doi: 10.1007/s11883-016-0562-9.
Coronary heart disease (CHD) is the leading cause of death in the United States. CHD risk differs between genders, with coronary events lagging behind ten years for women in comparison to men. Low-density lipoprotein cholesterol lowering with statin therapy is a major target for cardiovascular risk reduction. The benefit of statin therapy has been well established in men, for both primary and secondary prevention. However, the same has not been shown for women. While studies have demonstrated benefit in women for secondary prevention, their role in primary prevention of cardiovascular disease remains controversial. Data released over the past several years regarding statin efficacy and safety in men and women has been inconsistent, given that these studies had small sample sizes with numerous study limitations. A recent large scale meta-analysis of both primary and secondary statin prevention trials with sex-specific outcomes demonstrated a similar benefit in both men and women. Statins demonstrated a decrease in cardiovascular events and all-cause mortality in both sexes. In regards to statin safety, additional trials investigating the difference in adverse events of statins in men versus women, particularly new onset of diabetes, myalgias, and liver dysfunction, are warranted. Increased awareness and monitoring of female patients for myalgias and hyperglycemia should be considered as a precaution. Overall, women need to be better represented in prospective clinical trials powered to evaluate gender-specific differences in statin safety and efficacy in the management of cardiovascular disease.
冠心病（CHD）是美国的主要死因。CHD 风险存在性别差异，与男性相比，女性的冠心病事件滞后 10 年。用他汀类药物降低低密度脂蛋白胆固醇是降低心血管风险的主要目标。他汀类药物治疗的益处已在男性的一级和二级预防中得到充分证实。然而，女性并非如此。虽然研究表明女性在二级预防中受益，但她们在心血管疾病一级预防中的作用仍存在争议。由于这些研究的样本量较小且存在许多研究局限性，过去几年中关于他汀类药物在男性和女性中的疗效和安全性的数据不一致。最近一项针对主要和次要他汀类预防试验的大型荟萃分析显示，男性和女性的获益相似。他汀类药物可降低心血管事件和全因死亡率。关于他汀类药物的安全性，需要进一步的试验来研究男性和女性之间他汀类药物不良反应的差异，特别是新发糖尿病、肌痛和肝功能障碍。应增加对女性患者肌痛和高血糖的认识和监测，作为预防措施。总的来说，需要有更多的女性参与前瞻性临床试验，以评估他汀类药物在管理心血管疾病方面的安全性和疗效的性别差异。
