MedicalResearch.com Interview with:
Alexander Turchin, MD, MS
Associate Physician, Brigham and Women’s Hospital
Associate Professor of Medicine, Harvard Medical School
Brigham and Women’s Hospital
Department of Medicine
Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Turchin: It is known that fewer women than men at high risk for cardiovascular disease are treated with statins.
However, the reasons for this sex disparity are not fully understood.
Our study identified 4 factors that accounted for over 90% of the difference in statin therapy between women and men with coronary artery disease:
- Age (women were older than men),
- Amoking (men were more likely to smoke),
- Evaluation by a cardiologist (men were more likely to have been seen by a cardiologist) and
- History of adverse reactions to statins (women were more likely to have experienced an adverse reaction).
This is the first time that a near-complete explanation for the sex disparities in statin therapy was found.
MedicalResearch.com: What should readers take away from your report?
Dr. Turchin: Some of the differences in statin therapy between women and men appear to be due to men being perceived as being at higher cardiovascular risk (e.g. because they smoke). However, it is important to appreciate that all patients in the analysis already had coronary artery disease – an unequivocal indication for statin therapy. It may therefore not be appropriate to further risk stratify in this already very high-risk patient population.
Another important implication of our findings is that much of the sex difference in statin therapy was due to age differences. Older patients are generally less likely to be treated with statins, and women with coronary artery disease are on average older than men (due to their later onset of this condition). This stems in part from the lack of data on the effects of statin therapy in older patients – a gaping hole in our knowledge of treatment of the most common cause of death in the fastest growing segment of the population.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Turchin: It is important to study how we can effectively promote application of the current treatment guidelines (which call for statin therapy in all patients with coronary artery disease, regardless of additional cardiovascular risk factors) among the nation’s clinicians. It is also imperative that we study statin therapy in older patients – it is a shame that we know nothing about the effects of well-tolerated and easy-to-take medications in individuals who are at the highest risk for cardiovascular death.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Drivers of the Sex Disparity in Statin Therapy in Patients with Coronary Artery Disease: A Cohort Study
Huabing Zhang, Jorge Plutzky, Maria Shubina, Alexander Turchin
PLOS Published: May 5, 2016
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