Re: Should a women get a statin

MarilynMann wrote:
On Oct 31, 1:03 pm, "Juhana Harju" <n...@xxxxxxx> wrote:
MarilynMann wrote:
What do you propose for women who are at high cardiovascular risk?

A traditional Cretan type of Mediterranean diet, fish oil
supplementation, a daily glass of red wine and increased exercise
would be a good start. Inclusion of nuts to the daily diet is
important as that has been associated with hugely reduced
cardiovascular risk in women.

A fresh study:

Combined Effect of Low-Risk Dietary and Lifestyle Behaviors in
Primary Prevention of Myocardial Infarction in Women
Agneta Åkesson
[...]

The low-risk diet (high scores for the
healthy dietary pattern) characterized by a high intake of
vegetables, fruit, whole grains, fish, and legumes, in combination
with moderate alcohol consumption ( 5 g of alcohol per day), along
with the 3 low-risk lifestyle behaviors, was associated with 92%
decreased risk (95% confidence interval, 72%-98%) compared with
findings in women without any low-risk diet and lifestyle factors.
This combination of healthy behaviors, present in 5%, may prevent
77% of MIs in the study population.
[...]

women who ate more than five units of nuts (one unit equivalent to 1
oz of nuts) a week (frequent consumption) had a significantly lower
risk of total coronary heart disease (relative risk 0.65, 95%
confidence interval 0.47 to 0.89, P for trend=0.0009) than women who
never ate nuts or who ate less than one unit a month (rare
consumption).
[...]

Subjects who
consumed nuts frequently (more than four times per week) experienced
substantially fewer definite fatal CHD events (relative risk, 0.52;
95% confidence interval [CI], 0.36 to 0.76) and definite nonfatal
myocardial infarctions (relative risk, 0.49; 95% CI, 0.28 to 0.85) [...]

Our data strongly
suggest that the frequent consumption of nuts may protect against
risk of CHD events. The favorable fatty acid profile of many nuts is
one possible explanation for such an effect.

This is great, and I obviously don't disagree with making lifestyle
changes, but there are some women that are unwilling to do that or for
whom such changes are insufficient.

Fish oil capsules alone are probably more efficient for women than statins in reducing cardiovascular and total mortality. The meta-analysis below is not gender specific but as it is known that statins are less effective in women the mortality benefit for fish oils is likely to be even greater.


Arch Intern Med. 2005 Apr 11;165(7):725-30.
Effect of different antilipidemic agents and diets on mortality: a systematic review.
Studer M, Briel M, Leimenstoll B, Glass TR, Bucher HC.
Basel Institute for Clinical Epidemiology, University Hospital Basel, CH-4031 Basel, Switzerland.

BACKGROUND: Guidelines for the prevention and treatment of hyperlipidemia are often based on trials using combined clinical end points. Mortality data are the most reliable data to assess efficacy of interventions. We aimed to assess efficacy and safety of different lipid-lowering interventions based on mortality data. METHODS: We conducted a systematic search of randomized controlled trials published up to June 2003, comparing any lipid-lowering intervention with placebo or usual diet with respect to mortality. Outcome measures were mortality from all, cardiac, and noncardiovascular causes. RESULTS: A total of 97 studies met eligibility criteria, with 137,140 individuals in intervention and 138,976 individuals in control groups. Compared with control groups, risk ratios for overall mortality were 0.87 for statins (95% confidence interval [CI], 0.81-0.94), 1.00 for fibrates (95% CI, 0.91-1.11), 0.84 for resins (95% CI, 0.66-1.08), 0.96 for niacin (95% CI, 0.86-1.08), 0.77 for n-3 fatty acids (95% CI, 0.63-0.94), and 0.97 for diet (95% CI, 0.91-1.04). Compared with control groups, risk ratios for cardiac mortality indicated benefit from statins (0.78; 95% CI, 0.72-0.84), resins (0.70; 95% CI, 0.50-0.99) and n-3 fatty acids (0.68; 95% CI, 0.52-0.90). Risk ratios for noncardiovascular mortality of any intervention indicated no association when compared with control groups, with the exception of fibrates (risk ratio, 1.13; 95% CI, 1.01-1.27). CONCLUSIONS: Statins and n-3 fatty acids are the most favorable lipid-lowering interventions with reduced risks of overall and cardiac mortality. Any potential reduction in cardiac mortality from fibrates is offset by an increased risk of death from noncardiovascular causes. PMID: 15824290

Abstract:
http://tinyurl.com/2cucqn

Full study:
http://archinte.ama-assn.org/cgi/content/full/165/7/725


--
Juhana

http://ruohikolla.blogspot.com/

.

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