Reasons behind sex disparities in statin therapy.
A recent study identifies 4 major reasons that women are less likely to be prescribed cholesterol-lowering drugs than men.
"This is the first study to identify factors that explain almost all of the sex disparities in statin therapy," said researcher Alexander Turchin, MD, MS. "These results point the way to interventions that could decrease or eliminate sex disparities in statin therapy and have significant public health implications."
According to the study published by PLOS ONE, statins are effective in both men and women with coronary artery disease (CAD) and can decrease the risk of a second coronary event. However, previous studies have found that women are less likely to be prescribed statins, but the reasons why were not explored.
In the current study, researchers used state of the art natural language processing tools and reviewed the course of over 24,000 patients with CAD treated between 2000 and 2011.
Researchers found that only 81.9% of women started statin therapy compared with 87.7% of men. Also, only 67% of women continued taking statin therapy, compared with 71.4% of men.
According to the study, the 4 factors that influenced the likelihood of treatment with statins were: evaluation by a cardiologist, history of adverse reactions to statins, age, and smoking history.
Researchers noted that women were less likely to have been evaluated by a cardiologist and also less likely to report reactions to statins compared with men.
Younger patients and patients with a history of smoking were more likely to continue taking statins throughout the study, according to the researchers.
Women were likely to develop CAD 10 years later than men and also have lower smoking rates, which researchers believe contributes to the disparity.
These factors comprise 90% of the differences found between men and women and this data could potentially be used to develop interventions.
Researchers wrote that developing interventions could overcome disparities in lifesaving treatments. Cardiologists could help close the gap and have a more aggressive approach to lowering cholesterol in these groups.
"Our data reveal significant issues as well as opportunities for improving cardiovascular outcomes in women -- an important objective given the under-treatment and incidence of cardiovascular disease in women," said co-author Jorge Plutzky, MD. "Identifying the factors underlying decreased use of statins in women who should be treated is a first step toward overcoming these barriers and improving cardiovascular outcomes for women."