The gender-specific clinical pharmacology of statins: an update

When overlooked, underrepresentation in clinical trials and the difference in cardiovascular disease (CVD) symptoms in women may lead to worse outcomes and the recurrence of CVD. The efficacy of statins in women with CVD has been established in randomised clinical trials. However, the use of statins should be broadened and not be denied to women with high-risk CVD, in whom the benefits may be greater than those observed in men. There is also a major gender difference in the use of lipid-lowering drugs between men and women with CVD. Statin doses should be adjusted in patients with a high probability of potential side effects, especially with polydrug use. Although the association between statin use and incident diabetes is known, this risk appears to be higher amongst elderly women and shows a dose-response effect. Increasing evidence from observational studies indicates that the use of statins may delay the progression of breast cancer and other malignancies affecting women. Furthermore, interventional studies have shown that statin use may have benefits with regard to prevalent female conditions such as preeclampsia and polycystic ovary syndrome, suggesting novel gender-specific treatment options.