Boston—Because women are less likely to see cardiologists and more likely to report adverse reactions to the cholesterol-lowering drugs, they are significantly less likely to be prescribed statins, according to a new study.

The report, published recently in PLOS ONE, notes that statins are proven to be equally effective at decreasing risk of coronary event in both genders. Yet, the study notes that women were less likely to have started taking statin therapy (81.9% vs. 87.7%) or to have continued statin therapy (67% vs. 71.4%).

Researchers from Brigham and Women’s Hospital (BWH) in Boston sought to determine why and identify four factors that could help explain why prescribing is so different for women than men in patients with coronary artery disease (CAD).

“This is the first study to identify factors that explain almost all of the sex disparities in statin therapy,” pointed out corresponding author 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.”

Researchers reviewed the medical records of more than 24,000 patients with coronary artery disease treated at either BWH or Massachusetts General Hospital between 2000 and 2011.

Women were less likely than men to have been evaluated by a cardiologist, they report, calling that one factor contributing to lower rates of statin use. In addition, women were more likely than men to report adverse reactions to statins.

On the other hand, younger patients and those with a history of smoking were more likely to have continued taking statins through the study period. That worked against women’s use of statins, however, since they experience coronary artery disease an average of 10 years later and have lower smoking rates than men.

The four factors—evaluation by a cardiologist, history of adverse reaction to statins, age and smoking history—accounted for 90% of the differences seen between women and men in statin use, according to study authors.

“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,” explained 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.”

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