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Addressing Cardiovascular Disease in Women: Focus on Dyslipidemia

From the University of Pennsylvania, Philadelphia

Correspondence: Address correspondence to Emma A. Meagher, MD, Department of Medicine and Pharmacology, University of Pennsylvania School of Medicine, 9053 West Gates, 3400 Spruce St., Philadelphia, PA 19104-4283 (e-mail: emma{at}spirit.gcrc.upenn.edu)

Background: There is a need to better diagnose and treat women who may be at risk for cardiovascular disease. This is emphasized by the impending release of evidence-based guidelines for the prevention of cardiovascular disease in women. Dyslipidemia is one of the most important modifiable risk factors for coronary heart disease (CHD) and is the focus of the current literature review.

Methods: Medical literature on treating cardiovascular disease and cholesterol disorders in women was reviewed by searching Medline, including a selective search for randomized controlled clinical trials of lipid therapy. In addition, current dyslipidemia treatment guidelines were reviewed.

Results and Conclusions: Subgroup analyses of both primary and secondary prevention trials have shown that lipid-modifying drugs offer benefits to women comparable with those seen in men. Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-modifying therapy for the reduction of coronary risk. However, there are differences between the sexes in the lipid profile that may have clinical implications. In women, changes in high-density lipoprotein cholesterol (HDL-C) and triglyceride levels are better predictors of coronary risk than LDL-C or total cholesterol. Thus, treatment beyond LDL-C may be of greater importance in women than in men. Furthermore, treatment options that provide improvement in all aspects of the lipid profile should be considered.

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