Gender Differences in Statin Prescriptions for PAD and Ischemic Cerebrovascular Disease Interview with:

First Author:
Dhruv Mahtta, DO, MBA

Cardiovascular Disease Fellow
Baylor College of Medicine
Houston, TX

Senior & Corresponding Author

Dr. Virani

Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center, Houston, TX

Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation
Houston, TX @virani_md What is the background for this study? What are the main findings? What do you think accounts for the gender differences?

Response: We know that women with ischemic heart disease (IHD) have lower prescription rates for statin and high-intensity statin therapy. In this study, we assessed whether the same trends hold true for women with other forms of atherosclerotic cardiovascular disease (ASCVD) i.e. women with peripheral artery disease (PAD) or ischemic cerebrovascular disease (ICVD). Maximally tolerated statin therapy is a Class-I indication in patients with clinical ASCVD which includes PAD and ICVD.

We also assessed statin adherence among men and women with PAD and ICVD.

Lastly, we performed exploratory analyses to assess whether statin therapy, statin intensity, and statin adherence in women with PAD and ICVD were associated with cardiovascular outcomes and/or mortality. What should readers take away from your report?

Response: Compared to men with PAD, women with PAD had 32% lower odds of receiving a statin, 12% lower odds of receiving a high-intensity statin, and 25% lower odds of being adherent to statins. Compared to men with ICVD, women with ICVD had 35% lower odds of receiving a statin, 25% lower odds of receiving a high-intensity statin, and 22% lower odds of being adherent to statins. Among women with PAD or ICVD, statin use or high-intensity statin use were associated with a 29% and 32% lower odds of mortality whereas statin adherence was associated with a 24% lower odds of MI at one year of follow-up. What recommendations do you have for future research as a result of this work?

Response: This study is one of the largest investigations on this topic at the level of a health care system. Further research is needed to understand clinician and patient beliefs and practices which could be driving this disparity. At the same time, system-level interventions are needed to address these gaps at both the level of both clinicians and patients. 

Any disclosures?

Dr. Dhruv Mahtta reports no disclosures.

Dr. Salim S. Virani reports receiving grants from the US Department of Veterans Affairs (VA) during the conduct of the study and grants from the World Heart Federation and the Jooma and Tahir Family and honorarium from the American College of Cardiology in his role as the Associate Editor for Innovations 


Dhruv MahttaSarah T. AhmedMichelle LeeFatima RodriguezErin MichosDipti ItchhaporiaKhurram NasirMahboob AlamHani JneidChristie M. BallantyneLaura PetersenSalim Virani


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Last Updated on August 27, 2020 by Marie Benz MD FAAD