Statins for the primary prevention of cardiovascular events in women with elevated high-sensitivity C-reactive protein or dyslipidemia: results from the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and meta-analysis of women from primary prevention trials.

Description

Statin therapy for the primary prevention of cardiovascular disease (CVD) in women is controversial. The purpose of this paper was to conduct sex-specific analysis in JUPITER and perform a meta-analysis to compare the efficacy and safety of rosuvastatin therapy in women compared to men. The study included 6,801 women ≥60 years of age and the meta-analysis included 20,147 women with >276 CVD events. The results from the subgroup analysis indicated a statistically significant relative risk reduction in women as well as in men for the primary endpoint (hazard ratio=0.54, p=0.002 vs. 0.58, p<0.001, for women and men, respectively). In addition, women with a family history of premature coronary disease appeared to benefit more from rosuvastatin therapy than those without. In the meta-analysis, statin use generated a significant relative risk reduction in CVD of one-third, similar to prior results reported in men and in secondary prevention in women. Thus, these results suggest a comparable beneficial effect of rosuvastatin in primary prevention in women as well as men. In their editorial comment, Duvernoy CS and Blumenthal R discussed the context of statin therapy in primary prevention of CVD in women. They recognised that these findings challenge the current view regarding the role of statin therapy in primary prevention in women.