BMJ  2007;334:983 (12 May), doi:10.1136/bmj.39202.397488.AD

Feature

Head to head

Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? No

24 Prestwick Close, Tytherington, Macclesfield, Cheshire SK10 2TH

Women in western countries are more likely to die from heart disease than from cancer. Scott M Grundy argues that the risks make preventive treatment essential, but Malcolm Kendrick believes the evidence of benefit is not strong enough

The first 150 words of the full text of this article appear below.

As no other cholesterol lowering drug has been shown to improve survival, this discussion is effectively about the use of statins. To date, none of the large trials of secondary prevention with statins has shown a reduction in overall mortality in women.¹ Perhaps more critically, the primary prevention trials have shown neither an overall mortality benefit, nor even a reduction in cardiovascular end points in women.² This raises the important question whether women should be prescribed statins at all.

I believe that the answer is clearly no. Not only do statins fail to provide any overall health benefit in women, they represent a massive financial drain on health services. This money could be diverted to treatments of proved value.

In addition to the lack of benefit and expense, statins carry a substantial burden of side effects.^{3 4} Lifetime drug treatment can also create other problems. Firstly, women may falsely believe that . . . [Full text of this article]

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