Cangemi Roberto, Romiti Giulio Francesco, Campolongo Giuseppe, Ruscio Eleonora, Sciomer Susanna, Gianfrilli Daniele, Raparelli Valeria
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
Pharmacol Res. 2017 Mar;117:148-155. doi: 10.1016/j.phrs.2016.12.027. Epub 2016 Dec 21.
Statins are a main curbstone in the prevention of cardiovascular disease (CVD), pandemic in 21st century. CVD displays evident sex and gender differences, not only in clinical manifestation and outcomes but also in pharmacological treatment. Whether statin therapy should be differentially prescribed according to sex is a matter of debate. Aside a different pharmacological action, statins are not proven to be less effective in one gender comparing to the other, nor to be less safe. Nevertheless, up to date evidence shows that statins have not been adequately tested in women, especially in primary prevention trials. Since data-lacking, making a treatment decision on women is potentially harmful, although female individuals represent the majority of the population and they have a greater lifetime CVD risk. Therefore, adequately powered randomized control trials with longer follow-up are warranted to establish if a benefit on CV events and mortality prevention exists in both sexes. The aim of the present review is to summarize the sex and gender differences in statin use: it raises concerns and updates perspectives towards an evidence-based and sex-tailored prevention of CVD management.
他汀类药物是21世纪大流行的预防心血管疾病（CVD）的主要基石。CVD不仅在临床表现和结局方面，而且在药物治疗方面都表现出明显的性别差异。他汀类药物治疗是否应根据性别差异开具处方是一个有争议的问题。除了不同的药理作用外，没有证据表明他汀类药物在一种性别中比另一种性别效果更差，也没有证据表明其安全性更低。然而，最新证据表明，他汀类药物在女性中尚未得到充分测试，尤其是在一级预防试验中。由于缺乏数据，尽管女性占人口的大多数且她们一生中患CVD的风险更高，但对女性做出治疗决定可能是有害的。因此，有必要进行足够样本量且随访时间更长的随机对照试验，以确定他汀类药物对两性预防心血管事件和死亡率是否有益。本综述的目的是总结他汀类药物使用中的性别差异：它引发了人们的关注，并更新了对基于证据和针对性别的CVD管理预防的看法。
