BMJ  2007;334:1087 (26 May), doi:10.1136/bmj.39224.456632.59

Observations

Poll results

Should women be offered cholesterol lowering drugs to prevent cardiovascular disease?

In the online poll following our 12 May Head to head debate (BMJ 2007;334:982-3), 19% of 184 respondents said yes and 81% said no. Here are some of the comments we received:

NO "The benefit is too small compared to possible disadvantages."

YES "Statins are safe and effective drugs. No one disputes their effectiveness in reducing cholesterol, a known cardiovascular risk factor. To prevent global epidemic of cardiovascular disease (CVD), statins should be offered to all eligible patients, along with interventions to improve adherence."

NO "In Western society we are overmedicating in so many ways. Let's get back to lifestyle basics. Cholesterol lowering therapy is notoriously poor for patient adherence, which means that it's unlikely to be cost effective."

NO "If women don't carry any mortal risk factors, and the level of cholesterol isn't very high, I think any cholesterol lowering drug mustn't be given easily before trying to change lifestyle."

YES "Everyone should be entitled to standard treatment to prevent CVD. Even though women may be protected by oestrogen till menopause there may be other risk factors such as hereditary factors, or obesity, or smoking."

NO "There is not enough supervision after being put on statins. Yes, they lower the cholesterol count, but the side effects are very unpleasant. There should be more research into the side effects before blanket-covering the whole nation."

NO "Because no trial has ever shown statins or other cholesterol lowering drugs to extend survival in females. Even a 2004 meta-analysis publishing in the JAMA acknowledged this."

NO "Benefits have not been proved. Risks are numerous, especially for younger women who may become pregnant, and adverse side effects have been ignored or suppressed in advertisements and aggressive promotional efforts."

NO "Complete lack of evidence. Evidence of massively under-reported side effects (many of them far from benign) is mounting."

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Full poll results are available at http://resources.bmj.com/bmj/interactive/polls/lower-cholesterol.

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