Dyslipidemia in Women

There has been a great deal of growth in heart disease in women and recently, the movement has been a national phenomenon with the Red Dress Campaign, which is a “nationwide campaign to raise awareness that heart disease is women’s No. 1 killer ” (see www.americanheart.org) and highlight the discrepancy in research on women with heart disease. Indeed, although cardiovascular disease is the most common cause of death in men and women, many may not realize that more women than men actually die of cardiovascular disease. The fact of the matter is more women die from cardiovascular disease than any other disease. For example, in the year 2000, 440,175 men died of heart disease compared to 505,661 women died of heart disease .

One of the major contributors to cardiovascular disease is dyslipidemia or what is commonly known as hyperlipidemia. In general, it used to be thought that most women did not have as severe lipid disorders as men because the protective effect of estrogen, however, post-menopausal women tend to have equivalent rates of dyslipidemia as men. Much of the research on dyspidemia has sought to identify the risky lipid parameters that increase risk for heart disease, which entails a low HDL (good cholesterol), and high LDL and cholesterol level, without much talk of hypertriglyceridemia. However, recent research in women has found that there are different lipid parameters that increase their risk for heart disease, which is a low HDL and high triglycerides with less impact from high LDL . This discrepancy is not always noticed by physicians because most of the research was conducted on men.

The benefits of statins such as Lipitor and Zocor have been well documented in many old and new studies in reducing the risk of cardiovascular disease. These medications had previously thought to decrease heart disease and cardiovascular mortality directly by decreasing bad cholesterol levels (such as total cholesterol and LDL) and increasing good cholesterol (such as HDL), however, there is new evidence to suggest that statins play an anti-inflammatory role in reducing death from heart attacks. This has been confirmed in the fact that patients who take statins have lower levels of CRP (C-reactive protein), which is a marker of inflammation in the body in general. In fact, some cardiologist now recommend checking hs-CRP (high sensitivity CRP) in patients with risk factors for cardiovascular disease to be able to identify the highest risk patients.

Diabetes in women has a more negative effect on women heart health than on men. In fact, it is estimated that women with diabetes have a three to seven times higher risk of cardiovascular disease compared to men’s two to three times higher risk when compared to the general population . Once again, statin therapy in patients with diabetes has been a crucial medication in reducing cardiovascular disease in all diabetics with dyslipidemia. In fact, in an even more convincing study, which was recently published, a more aggressive approach to diabetics was taken where all diabetics regardless of their cholesterol levels were treated with low dose therapy without any major side effects and a significant decrease in cardiovascular disease .

1. National Center for Health Statistics. Vital Statistics of the United States, 1989. Vol 11. Mortality, Part A. Washington,
DC: Government Printing Office; 1993. DHHS publication (PHS) 93-1101.

2. Mosca L, Grundy SM, Judelson D, et al. Guide to preventive cardiology for women. J Am Coll Cardiol. 1999; 33:1751-1755.

3. Gu K, Cowie CC, Harris MI. Diabetes and decline in heart disease mortality in US adults. JAMA. 1999;281:1291-1297.

4. Colhoun HM, Betteridge JD, Durrington PN et al.; Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomized placebo-controlled trial. Lancet 2004: 364

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