Statin Therapy in Women Halves the Risk of Heart Disease

A deeper analysis of a large statin study has revealed some additional information of interest to women.  JUPITER (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin) was a long-term, randomized, double-blind, placebo-controlled, study of 17,800 patients; its purpose was to determine if rosuvastatin (Crestor®) 20 mg decreases the risk of heart attack, stroke and other major cardiovascular events in patients with low to normal LDL-C (the ‘bad’ cholesterol) but at increased risk, as identified by elevated C-reactive protein (CRP) and age.  The findings from the 6,800 apparently healthy women who were enrolled were reported at the American Heart Association meeting in November.

The important result of this analysis is that women taking the statin had a similar and significant reduction in cardiovascular events (heart attack, stroke, etc) as the men in the study.  However, it wasn’t quite as pronounced.  Using the ‘number needed to treat’ analysis, it would take 36 women treated with rosuvastatin for 2 years to prevent one heart attack, cardiac death, stroke, or need for revascularization; for the whole study (men and women) the number needed to treat was 25.  (These may seem unreasonably high numbers to a lay person, but they aren’t exceptional for drugs taken to protect against a lethal or severe event.)

On the negative side, a higher incidence of type 2 diabetes was reported in women on the statin (1.59%), but not in men (1.42%); the placebo group incidences were 1.05% and 1.32% for women and men, respectively. 

The good news from this analysis is that a statin is effective in helping prevent adverse cardiac effects (including stroke) in women who are apparently healthy, with a normal cholesterol pattern but a one-time CRP elevation.  With the value of CRP still a little dubious – elevation indicates an inflammatory process somewhere in the body – it’s clear that statins can be useful preventive meds in both men and women.