Gender difference in coronary events in relation to risk factors in Japanese hypercholesterolemic patients treated with low-dose simvastatin.
BACKGROUND
Gender differences between the risk factors for coronary heart disease and coronary events were examined in the Japan Lipid Intervention Trial, a 6-year observational study.


RESULTS
Men (12,575) and women (27,013) were analyzed for risk of coronary events (acute myocardial infarction and sudden cardiac death). Simvastatin reduced serum low-density lipoprotein cholesterol (LDL-C) by 27% in both genders, and increased serum high-density lipoprotein cholesterol (HDL-C) in men (5%) and women (4%). The incidence of coronary events was lower in women (0.64/1,000 patient-years) than in men (1.57/1,000 patient-years). The risk of coronary events increased by 18% in men and 21% in women with each 10 mg/dl elevation of LDL-C, and decreased by 39% in men and 33% in women with each 10 mg/dl elevation of HDL-C. The risk increased proportionally with aging in women, but not in men. Diabetes mellitus (DM) was more strongly related to the risk of coronary events for women (relative risk 3.07) than for men (relative risk 1.58).


CONCLUSIONS
The incidence of coronary events is lower in women. Serum LDL-C is related to an increased risk of coronary events to the same extent in both genders. DM seems to be a more important risk factor in women, trading off the lower risk of coronary events among them.
Sasaki
Jun
J
International University of Health and Welfare Graduate School of Clinical Trial Management, Fukuoka, Japan.
Kita
Toru
T
Mabuchi
Hiroshi
H
Matsuzaki
Masunori
M
Matsuzawa
Yuji
Y
Nakaya
Noriaki
N
Oikawa
Shinichi
S
Saito
Yasushi
Y
Shimamoto
Kazuaki
K
Kono
Suminori
S
Itakura
Hiroshige
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D044466:Asian People; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D003643:Death; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D019821:Simvastatin / Q000008:administration & dosage*
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019821:Simvastatin