AstraZeneca Gothenburg, Mölndal, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Manchester Metropolitan University, Manchester, UK.
Atherosclerosis. 2017 Oct;265:54-59. doi: 10.1016/j.atherosclerosis.2017.08.014. Epub 2017 Aug 19.
The effectiveness of statins in the treatment of dyslipidaemia and reduction of cardiovascular risk is well established. However, the association of statin-mediated lipid effects with age and gender is unclear. This study aimed to determine whether age and gender are associated with statin-mediated changes in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and non-HDL-C.
Individual patient data (n = 32,258) were obtained from VOYAGER. Least-squares mean percentage change from baseline in LDL-C, non-HDL-C and HDL-C with atorvastatin 10-80 mg, rosuvastatin 5-40 mg or simvastatin 10-80 mg was estimated in women aged <70 years, women aged ≥70 years, men aged <70 years and men aged ≥70 years.
All statins and doses gave significant dose-dependent reductions in LDL-C and non-HDL-C, and increases in HDL-C, in all four patient groups. A 2.1% greater reduction in LDL-C was observed in women, compared with men (p < 0.0001). Patients aged ≥70 years experienced a 2.7% greater reduction in LDL-C compared with younger patients (p < 0.0001). Similar results were also observed for statin-mediated changes in non-HDL-C. Men experienced a significantly greater increase in HDL-C than women, and patients aged ≥70 years achieved a significantly greater increase than younger patients (both p = 0.001).
While statins improve the lipid profile in all gender and age groups analysed, the improvements are greater in women than in men and in those aged ≥70 years compared with those aged <70 years.
他汀类药物在治疗血脂异常和降低心血管风险方面的疗效已得到充分证实。然而,他汀类药物介导的脂质效应与年龄和性别之间的关系尚不清楚。本研究旨在确定年龄和性别是否与他汀类药物介导的低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和非高密度脂蛋白胆固醇(non-HDL-C)变化相关。
从 VOYAGER 中获取了 32258 名患者的个体患者数据。阿托伐他汀 10-80mg、瑞舒伐他汀 5-40mg 或辛伐他汀 10-80mg 治疗时,<70 岁女性、≥70 岁女性、<70 岁男性和≥70 岁男性患者的 LDL-C、non-HDL-C 和 HDL-C 与基线相比的最小二乘均数百分比变化。
在所有四组患者中,所有他汀类药物和剂量均显著降低 LDL-C 和 non-HDL-C,增加 HDL-C,且与剂量呈依赖性。与男性相比,女性 LDL-C 降低幅度更大(2.1%;p<0.0001)。与年轻患者相比,≥70 岁患者 LDL-C 降低幅度更大(2.7%;p<0.0001)。non-HDL-C 变化也观察到了类似的他汀类药物介导结果。男性的 HDL-C 增加幅度明显大于女性,≥70 岁患者的 HDL-C 增加幅度明显大于年轻患者(均 p=0.001)。
尽管他汀类药物改善了所有分析的性别和年龄组的血脂谱,但女性和≥70 岁患者的改善幅度大于男性和<70 岁患者。