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

doi:10.1136/bmj.39202.399942.AD

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ comment articles:

From

Limit by

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Scott M Grundy, professor

Center for Human Nutrition, Departments of Clinical Nutrition and Internal Medicine, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9052, USA

scott.grundy@utsouthwestern.edu

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

Primary and secondary trials show that cholesterol lowering drugs reduce the risk of cardiovascular disease events in men.1 2 Secondary prevention trials in women with established cardiovascular disease also show a reduction in risk.3 4 5 Meta-analyses also show that when all women with or without cardiovascular disease are combined, cholesterol lowering treatment produces benefit.6 7

Some investigators nevertheless argue that women without cardiovascular disease should not be given cholesterol lowering drugs because of insufficient evidence from primary prevention trials in women.8 They speculate that women with and without cardiovascular disease respond differently to the drugs; if true, women may not respond to treatment even when they have the same level of risk as men who do benefit.1 2 This speculation discounts prospective studies showing that raised cholesterol …