Re: Do drugs {including statins} and procedures benefit women and men equally?

On Sep 12, 10:38 am, Jim Chinnis <jchin...@xxxxxxxxxxxxxxxx> wrote:
bigvince <Vince.Mirag...@xxxxxxxxx> wrote in part:



On Sep 11, 4:02 pm, Jim Chinnis <jchin...@xxxxxxxxxxxxxxxx> wrote:
bigvince <Vince.Mirag...@xxxxxxxxx> wrote in part:

ASCOT-LLA (2003)
ASCOT-LLA (Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering
Arm) was designed to assess the benefits of atorvastatin (Lipitor)
versus a placebo in patients who had high blood pressure with average
or lower-than-average cholesterol concentrations and at least three
other cardiovascular risk factors.48 The trial was originally planned
for five years but was stopped after a median follow-up of 3.3 years
because of a significant reduction in cardiac events. Lipitor did
reduce total myocardial infarction and total stroke; however, total
mortality was not significantly reduced. In fact, women were worse off
with treatment. The trial report stated that total serious adverse
events "did not differ between
patients assigned atorvastatin or placebo," but did not supply the
actual numbers of serious events.

This was for primary prevention.

Jim heres my original comment

"As some studies have suggested that statins also have even less
value
in women does the one size fits all approach in the ATP guidelines
need rethinking. '

Where in that comment do you see a restiction on studys on primary
prevention . The Ascott study is relavent to my comment .Thanks
Vince

Your original POST was a news story about women with heart disease ("clogged
arteries). You took a news story about how women with clogged arteries might
need different procedures than men and ran with it.

The news item from your post:

*********************
Women With Heart Conditions Might Need Different Treatments Than Men
With Similar Conditions, Doctors Sayhttp://www.medicalnewstoday.com/articles/81448.php

Researchers at the annual meeting of the European Society of
Cardiology in Vienna, Austria, on Monday said that women with heart
conditions might need different treatments than men and that the issue
needs to be studied further, the AP/Hartford Courant reports.

The American College of Cardiology last month revised its treatment
guidelines to recommend that doctors be more cautious about subjecting
women at low risk of heart disease to invasive procedures. According
to the AP/Courant, an example of increased caution would be a
physician waiting to see if further symptoms develop in a woman with a
clogged artery rather than performing an angioplasty, which involves
inflating a tiny balloon in the clogged vessel. Guidelines in Europe
for treating heart disease are usually the same for men and women, the
AP/Courant reports.

Eva Swahn of the department of cardiology at University Hospital in
Linkoping, Sweden, on Monday presented a study of 184 women with heart
conditions. The women were divided into two equal groups: one in which
the women underwent an invasive procedure -- such as a coronary bypass
surgery or an angioplasty -- and a second group in which women waited
until further symptoms developed. Eight of the women who underwent an
invasive procedure died after one year, compared with one death in the
group of women who waited for further diagnosis."..........

As some studies have suggested that statins also have even less value
in women does the one size fits all approach in the ATP guidelines
need rethinking.
--
Jim Chinnis Warrenton, Virginia, USA

I posted the link and assumed you read the article. The reference to
the ATP guidelines I thought was clear enough.from the piece I posted

According to the AP/Courant, physicians are not sure what accounts
for the differences. Women typically have smaller hearts and vessels,
which can complicate procedures that require instruments such as
catheters. Women also tend to have more side effects from medicines,
and hormones also might be factors. In addition, women are usually
about 10 years older than men when they develop heart conditions, so
other health problems linked to old age could also increase their risk
of heart surgery complications, the AP/Courant reports.

Comments
"There is a big question mark over why this is happening," Swahn --
who consults for some pharmaceutical companies and is writing a book
for AstraZeneca -- said, adding, "We want there to be equality between
the genders, but that doesn't mean that women and men should get the
same treatment." Swahn's study was part of a larger study funded by
pharmaceutical companies Sanofi-Aventis and GlaxoSmithKline.

Some experts said no definitive conclusions can be taken from Swahn's
study but added that gender differences in heart treatments should be
studied further. "We have had hints in the past that women don't
respond to treatment in exactly the same way as men," Christopher
Cannon, an associate professor of medicine at Harvard University and
spokesperson for A'CC, said. Cannon was not associated with Swahn's
research (Cheng, AP/Hartford Courant, 9/3).

In either case significant reduction in mortality has never been shown
for women in any study or meta analysis . That holds true in women
across the board with or without CVD. If you have a study or meta
analysis that disproves that statement please post it. And perhaps you
could comment on the Ascott study another trail where women fared less
well on treatment
Thanks Vince

.

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