Gheorghe Gina, Toth Peter P, Bungau Simona, Behl Tapan, Ilie Madalina, Pantea Stoian Anca, Bratu Ovidiu Gabriel, Bacalbasa Nicolae, Rus Marius, Diaconu Camelia Cristina
Department 5, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Diagnostics (Basel). 2020 Jul 16;10(7):483. doi: 10.3390/diagnostics10070483.
Despite major progress in the prevention and treatment of cardiovascular diseases, women remain an underdiagnosed and insufficiently treated group, with higher hospitalization and death rates compared to men. Obesity, more frequently encountered in women, raises the risk of metabolic syndrome and cardiovascular diseases as women age. There are some differences based on sex regarding the screening, diagnosis, and treatment of dyslipidemia, as it has been observed that women are less frequently prescribed statins and, when they are, they receive lower doses, even after myocardial infarction or coronary revascularization. Real-life data show that, compared to men, women are at higher risk of non-adherence to statin treatment and are more predisposed to discontinue treatment because of side effects. Statin metabolism has some particularities in women, due to a lower glomerular filtration rate, higher body fat percentage, and overall faster statin metabolism. In women of fertile age, before initiating statin treatment, contraception methods should be discussed because statins may have teratogenic effects. Older women have a higher likelihood of polypharmacy, with greater potential for drug interactions when prescribing a statin.
尽管在心血管疾病的预防和治疗方面取得了重大进展，但女性仍然是诊断不足和治疗不充分的群体，与男性相比，她们的住院率和死亡率更高。肥胖在女性中更为常见，随着女性年龄的增长，肥胖会增加代谢综合征和心血管疾病的风险。在血脂异常的筛查、诊断和治疗方面，存在一些基于性别的差异，因为据观察，女性较少被处方使用他汀类药物，即使使用，剂量也较低，即使在心肌梗死或冠状动脉血运重建后也是如此。实际数据表明，与男性相比，女性不坚持他汀类药物治疗的风险更高，并且由于副作用更倾向于停药。由于肾小球滤过率较低、体脂百分比较高以及他汀类药物代谢总体较快，他汀类药物在女性中的代谢有一些特殊性。在育龄期女性中，在开始他汀类药物治疗之前，应讨论避孕方法，因为他汀类药物可能有致畸作用。老年女性多重用药的可能性更高，在开具他汀类药物处方时发生药物相互作用的可能性更大。
