Sex and the Statin: Are Women Less Likely to Get a Prescription?
Female patients are less likely to be prescribed statins than male patients, researchers from Brigham and Women's Hospital reported in a retrospective study. The findings are published in PLOS ONE.
Current guidelines recommend statin therapy for all adults with coronary artery disease (CAD). As the mortality rate for CAD has significantly decreased over the past 30 years, this reduction has been much greater for males than females. The reasons for prescribing disparities between men and women, however, have been unclear. In the study, Alexander Turchin, MD, MS, and colleagues describe 4 factors that may explain the gender gap in statin therapy among patients with CAD.
The team reviewed patients with CAD who were followed-up for at least 1 year between 2000–2011 (n=24,338). Female patients were less likely to have either initiated statin therapy (81.9% women vs. 87.7% men) or to have continued statin therapy at the end of follow-up (67.0% vs. 71.4%). In the study, the female patients were older (72.9 years vs. 68.4 years), were less likely to have ever smoked (49.8% vs. 65.6%), less likely to have been seen by a cardiologist (57.5% vs. 64.5%), and more likely to have reported an adverse effect from a statin (27.1% vs. 21.7%) (P values <0.0001 for all).
The multivariate analysis indicated that persistent statin therapy was more likely in patients with a history of smoking (odds ratio [OR] 1.094; P=0.017), younger age (OR 1.013 per year), cardiologist evaluation (OR 1.337), and no reported adverse effect from statins (OR 1.410) (P values <0.0001 for all).
"These four factors accounted for 90.4% of the sex disparity in persistent statin therapy," Dr. Turchin reported.
Understanding these specific drivers may "facilitate programmatic interventions and stimulate further research to overcome sex differences in applying proven interactions for cardiovascular risk reduction."
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