title: Gender related differences in treatment and response to statins in primary and secondary cardiovascular prevention: The never-ending debate.
abstract: Statins are a main curbstone in the prevention of cardiovascular disease (CVD), pandemic in 21st century. CVD displays evident sex and gender differences, not only in clinical manifestation and outcomes but also in pharmacological treatment. Whether statin therapy should be differentially prescribed according to sex is a matter of debate. Aside a different pharmacological action, statins are not proven to be less effective in one gender comparing to the other, nor to be less safe. Nevertheless, up to date evidence shows that statins have not been adequately tested in women, especially in primary prevention trials. Since data-lacking, making a treatment decision on women is potentially harmful, although female individuals represent the majority of the population and they have a greater lifetime CVD risk. Therefore, adequately powered randomized control trials with longer follow-up are warranted to establish if a benefit on CV events and mortality prevention exists in both sexes. The aim of the present review is to summarize the sex and gender differences in statin use: it raises concerns and updates perspectives towards an evidence-based and sex-tailored prevention of CVD management.
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy. Electronic address: roberto.cangemi@uniroma1.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cangemi
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
authors.forename: Giulio Francesco
authors.initials: GF
authors.lastname: Romiti
authors.affiliation: IRCSS San Raffaele Pisana, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Campolongo
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Ruscio
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University of Rome, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Sciomer
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Gianfrilli
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Raparelli
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002319:Cardiovascular System / Q000187:drug effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D012727:Sex Characteristics
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiovascular disease; Gender-oriented prevention; Prevention; Sex; Sex-tailored treatment; Statins