October 6, 2007. 8:49 p.m.

 Should I Give My Wife a Statin? Do I Dare To Eat a Peach?
 
I shall wear white flannel trousers and walk upon the beach.
 
You may have read that heart disease is under diagnosed in women,  
and that they are missing potential treatments that could save their lives.  
For instance, in the May 10, 2004, edition of Newsweek, it was  
reported that heart disease is a “grave threat to women’s health,  
but no one needs to take it lying down. Statin drugs (Zocor, Lipitor, Pravachol and others)  
can slash a woman’s heart-attack risk by more than a third—just  
as they do in men… should you be taking one of these medications?”  
The answer is—probably not. In a study that combined all of the available  
information on women from the different clinical trials, the authors  
found no reduction in heart attacks or mortality in women with high  
cholesterol who did not have a history of heart disease.  
That means that if you are a woman with high cholesterol who does  
not have a history of heart disease, you should not take a statin.  
But what if my cholesterol is elevated? You might ask. Just because  
your cholesterol is high, and statins reduce it, doesn’t mean it will  
prevent heart attacks or death. As seen in the ALL-HAT study, LDL  
cholesterol came down with statins, but there was no reduction in mortality.  
At this time there is no evidence that statins save the lives of women even  
f they have a history of heart disease. For women who are post-menopausal  
with heart disease, although the Heart Protection Study showed a reduction in  
heart attacks (with no reduction in mortality), more studies, including ASCOT,  
LIPID, and PROSPER, did not show any benefit. The 4S study found a 12% increase  
in overall mortality for women, even though there was a 24% reduction in heart  
disease related mortality. The CARE study showed a 12 fold increase in breast  
cancer in women, which may explain the increased overall mortality in spite of  
the reduced cardiac mortality. For women without heart disease or pre menopausal  
women (even with risk factors) there is no proven benefit to taking statins.  
Yet, that did not stop a national consortium of experts on women’s health  
sponsored by the American Heart Association, National Institute of Health, and a  
wide range of other organizations, from advocating statins for women without heart disease.

Doug Bremner, MD, is a physician
and researcher in Atlanta GA
and author of Before You Take That Pill:
Why the Drug Industry May be
Bad for Your Health

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