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Dyslipidemia and Cardiovascular Disease in Women

  • Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)
  • Published:
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Abstract

Cardiovascular disease is the major cause of death in women in developed countries. Dyslipidemia is highly prevalent in women, particularly after the menopause. Elevated low-density lipoprotein cholesterol (LDL-C) has been identified as the key lipid parameter in both genders whereas HDL-cholesterol and triglycerides have been more closely associated, in some studies, with cardiovascular risk in women. Menopause has been shown to be associated with an increase in total and LDL-cholesterol and a decrease in HDL-cholesterol (predominantly in the HDL2 subfraction). Despite its beneficial effects on the lipid profile, hormone replacement therapy is not recommended for primary or secondary prevention of cardiovascular disease in women. The latest meta-analysis of statin trials with gender-specific outcomes showed a similar benefit in women and men. The addition of ezetimibe to simvastatin in patients with acute coronary syndromes showed a further reduction of the primary endpoint in both genders. While there are no gender-related differences in drug treatment of dyslipidemia, current guidelines, to avoid overtreatment, strongly suggest risk estimation before initiating lipid-lowering treatment in women without manifest cardiovascular disease.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Nichols M, Townsend N, Scarborough P, et al. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J. 2014;35:2950–9. This paper provides an update for 2014 on the burden of CVD (and CHD and stroke in particular) across Europe.

    Article  PubMed  Google Scholar 

  2. Go AS, Mozaffarian D, Roger VL, et al. American heart association statistics committee and stroke statistics subcommittee. Heart disease and stroke statistics—2014 update: a report from the american heart association. Circulation. 2014;129:e28–292.

    Article  PubMed  Google Scholar 

  3. Yusuf S, Hawken S, Ounpuu S, et al. INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937–52.

    Article  PubMed  Google Scholar 

  4. Ouyang P, Michos ED, Karas RH. Hormone replacement therapy and the cardiovascular system lessons learned and unanswered questions. J Am Coll Cardiol. 2006;47:1741–53.

    Article  CAS  PubMed  Google Scholar 

  5. Mosca L, Banka CL, Benjamin EJ, et al. Expert panel/writing group; american heart association; american academy of family physicians; american college of obstetricians and gynecologists; american college of cardiology foundation; society of thoracic surgeons; american medical women’s association; centers for disease control and prevention; office of research on women’s health; association of black cardiologists; american college of physicians; world heart federation; national heart, lung, and blood institute; american college of nurse practitioners. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007;115:1481–501.

    Article  PubMed  Google Scholar 

  6. Rydén L, Grant PJ, Anker SD, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J. 2013;34:3035–87. These guidelines were developed to highlight the high risk of diabetes and pre-diabetes for cardiovascular disease; the publication contains updates references on this topic and recommendations.

    Article  PubMed  Google Scholar 

  7. Vaccarino V, Parsons L, Every NR, et al. Sex-based differences in early mortality after myocardial infarction. National Registry of Myocardial Infarction 2 Participants. N Engl J Med. 1999;341:217–25.

    Article  CAS  PubMed  Google Scholar 

  8. Seshadri S, Beiser A, Kelly-Hayes M, et al. The lifetime risk of stroke: estimates from the Framingham study. Stroke. 2006;37:345–50.

    Article  PubMed  Google Scholar 

  9. Statistics Canada; www.statcan.gc.ca.

  10. Perk J, De Backer G, Gohlke H, et al. European association for cardiovascular prevention & rehabilitation (EACPR); ESC committee for practice guidelines (CPG). european guidelines on cardiovascular disease prevention in clinical practice (version 2012). the fifth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33:1635–701.

    Article  CAS  PubMed  Google Scholar 

  11. Cífková R, Skodová Z, Bruthans J, et al. Longitudinal trends in cardiovascular mortality and blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2007/2008. J Hypertens. 2010;28:2196–203.

    Article  PubMed  Google Scholar 

  12. World Health Organization. The world health report 2002: Reducing risks, promoting healthy life. Geneva: World Health Organization; 2002

  13. Prescott E, Hippe M, Schnohr P, et al. Smoking and risk of myocardial infarction in women and men: longitudinal population study. BMJ. 1998;316:1043–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Mucha L, Stephenson J, Morandi N, et al. Meta-analysis of disease risk associated with smoking, by gender and intensity of smoking. Gend Med. 2006;3:279–91.

    Article  PubMed  Google Scholar 

  15. Benowitz NL, Lessov-Schlaggar CN, Swan GE. Female sex and oral contraceptive use accelerate nicotine metabolism. Clin Pharmacol Ther. 2006;79:480–8.

    Article  CAS  PubMed  Google Scholar 

  16. Keys A, Menotti A, Aravanis C, et al. The seven countries study: 2,289 deaths in 15 years. Prev Med. 1984;13:141–54.

    Article  CAS  PubMed  Google Scholar 

  17. Kannel WB, Castelli WP, Gordon T. Cholesterol in the prediction of atherosclerotic disease. New perspectives based on the Framingham study. Ann Intern Med. 1979;90:85–91.

    Article  CAS  PubMed  Google Scholar 

  18. European Association for Cardiovascular Prevention & Rehabilitation, Reiner Z, Catapano AL, De Backer G, et al. ESC committee for practice guidelines (CPG) 2008-2010 and 2010–2012 committees. ESC/EAS guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the European society of cardiology (ESC) and the European atherosclerosis society (EAS). Eur Heart J. 2011;32:1769–818.

    Article  Google Scholar 

  19. Stone NJ, Robinson JG, Lichtenstein AH, et al. American college of cardiology/american heart association task force on practice guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the american college of cardiology/american heart association task force on practice guidelines. Circulation. 2014;129(25 Suppl 2):S1–45. These recommendations provide a strong, evidence-based foundation for the treatment of cholesterol for the primary and secondary prevention of atherosclerotic CVD; no goals for LDL-cholesterol are defined.

    Article  PubMed  Google Scholar 

  20. Sarwar N, Danesh J, Eiriksdottir G, et al. Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies. Circulation. 2007;115:450–8.

    Article  CAS  PubMed  Google Scholar 

  21. Bass KM, Newschaffer CJ, Klag MJ, et al. Plasma lipoprotein levels as predictors of cardiovascular death in women. Arch Intern Med. 1993;153:2209–16.

    Article  CAS  PubMed  Google Scholar 

  22. Freedman DS, Bowman BA, Srinivasan SR, et al. Distribution and correlates of high-density lipoprotein subclasses among children and adolescents. Metabolism. 2001;50:370–6.

    Article  CAS  PubMed  Google Scholar 

  23. Freedman DS, Bowman BA, Otvos JD, et al. Levels and correlates of LDL and VLDL particle sizes among children: the Bogalusa heart study. Atherosclerosis. 2000;152:441–9.

    Article  CAS  PubMed  Google Scholar 

  24. Gardner CD, Winkleby MA, Fortmann SP. Population frequency distribution of non-high-density lipoprotein cholesterol (Third National Health and Nutrition Examination Survey [NHANES III], 1988–1994). Am J Cardiol. 2000;86:299–304.

    Article  CAS  PubMed  Google Scholar 

  25. Schaefer EJ, Lamon-Fava S, Cohn SD, et al. Effects of age, gender, and menopausal status on plasma low density lipoprotein cholesterol and apolipoprotein B levels in the Framingham Offspring Study. J Lipid Res. 1994;35:779–92.

    CAS  PubMed  Google Scholar 

  26. LaRosa JC. Lipoproteins and CAD risk in women. J Myocardial Ischemia. 1991;3:35–42.

    Google Scholar 

  27. Jenner JL, Ordovas JM, Lamon-Fava S, et al. Effects of age, sex, and menopausal status on plasma lipoprotein (a) levels. The Framingham Offspring Study. Circulation. 1993;87:1135–41.

    Article  CAS  PubMed  Google Scholar 

  28. Bonithon-Kopp C, Scarabin PY, Darne B, et al. Menopause-related changes in lipoproteins and some other cardiovascular risk factors. Int J Epidemiol. 1990;19:42–8.

    Article  CAS  PubMed  Google Scholar 

  29. Kolovou GD, Anagnostopoulou KK, Salpea KD, et al. Postprandial lipemia in postmenopausal women with high fasting high-density lipoprotein cholesterol. Am J Med Sci. 2006;331:10–6.

    Article  PubMed  Google Scholar 

  30. Couillard C, Bergeron N, Prud’homme D, et al. Gender difference in postprandial lipemia: importance of visceral adipose tissue accumulation. Arterioscler Thromb Vasc Biol. 1999;19:2448–55.

    Article  CAS  PubMed  Google Scholar 

  31. Kolovou G, Anagnostopoulou K, Kostakou P, et al. Association between the TaqIB polymorphism in the cholesteryl ester transfer protein gene locus and postprandial plasma lipoprotein levels in heterozygotes for familial hypercholesterolemia. Clin Chem Lab Med. 2007;45:1190–8.

    Article  CAS  PubMed  Google Scholar 

  32. Kovár J, Poledne R. Sex differences in the response of postprandial lipemia to a change from a low-fat low-cholesterol diet to a high-fat high-cholesterol diet. Physiol Res. 2000;49:233–9.

    PubMed  Google Scholar 

  33. Kolovou GD, Anagnostopoulou KK, Pilatis ND, et al. The influence of natural menopause on postprandial lipemia in heterozygotes for familial hypercholesterolemia. J Womens Health (Larchmt). 2004;13:1119–26.

    Article  Google Scholar 

  34. Godsland IF, Wynn V, Crook D, et al. Sex, plasma lipoproteins, and atherosclerosis: prevailing assumptions and outstanding questions. Am Heart J. 1987;114:1467–503.

    Article  CAS  PubMed  Google Scholar 

  35. Tikkanen MJ, Nikkilä EA, Kuusi T, et al. High density lipoprotein-2 and hepatic lipase: reciprocal changes produced by estrogen and norgestrel. J Clin Endocrinol Metab. 1982;54:1113–7.

    Article  CAS  PubMed  Google Scholar 

  36. Stampfer MJ, Willett WC, Colditz GA, et al. A prospective study of past use of oral contraceptive agents and risk of cardiovascular diseases. N Engl J Med. 1988;319:267–73.

    Article  CAS  PubMed  Google Scholar 

  37. Dunn N, Thorogood M, Faragher B, et al. Oral contraceptives and myocardial infarction: results of the MICA case–control study. BMJ. 1999;318:1579–83.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Tanis BC, van den Bosch MA, Kemmeren JM, et al. Oral contraceptives and the risk of myocardial infarction. N Engl J Med. 2001;345:1787–93.

    Article  CAS  PubMed  Google Scholar 

  39. Margolis KL, Adami HO, Luo J, et al. A prospective study of oral contraceptive use and risk of myocardial infarction among Swedish women. Fertil Steril. 2007;88:310–6.

    Article  PubMed  Google Scholar 

  40. Chakhtoura Z, Canonico M, Gompel A, et al. Progestogen-only contraceptives and the risk of acute myocardial infarction: a meta-analysis. J Clin Endocrinol Metab. 2011;96:1169–74.

    Article  CAS  PubMed  Google Scholar 

  41. Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives. A meta-analysis. JAMA. 2000;284:72–8.

    Article  CAS  PubMed  Google Scholar 

  42. Chan WS, Ray J, Wai EK, et al. Risk of stroke in women exposed to low-dose oral contraceptives. A critical evaluation of the evidence. Arch Intern Med. 2004;164:741–7.

    Article  PubMed  Google Scholar 

  43. Baillargeon J, McClish D, Essah P, et al. Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab. 2005;90:3863–70.

    Article  CAS  PubMed  Google Scholar 

  44. Lidegaard O, Nielsen LH, Skovlund CW, et al. Venous thrombosis in users of nonoral hormonal contraception: follow-up study, Denmark 2001–10. BMJ. 2012;344:e2990.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Brynhildsen J. Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks. Ther Adv Drug Saf. 2014;5:201–13.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Shufelt CL, Merz NB. Contraceptive hormone use and cardiovascular disease. J Am Coll Cardiol. 2009;53:221–31.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  47. World Health Organization. Medical eligibility criteria for contraceptive use. 3rd ed. Geneva: World Health Organization; 2004

  48. Lubianca JN, Moreira LB, Gus M, et al. Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension. J Hum Hypertens. 2005;19:451–5.

    Article  CAS  PubMed  Google Scholar 

  49. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2006;107:1453–72.

  50. Lewis CE, Funkhouser E, Raczynski JM, et al. Adverse effect of pregnancy on high density lipoprotein (HDL) cholesterol in young adult women. The CARDIA study. Coronary artery risk development in young adults. Am J Epidemiol. 1996;144:247–54.

    Article  CAS  PubMed  Google Scholar 

  51. van Stiphout WA, Hofman A, de Bruijn AM. Serum lipids in young women before, during, and after pregnancy. Am J Epidemiol. 1987;126(5):922–8.

    PubMed  Google Scholar 

  52. van Beresteijn EC, Korevaar JC, Huijbregts PC, et al. Perimenopausal increase in serum cholesterol: a 10-year longitudinal study. Am J Epidemiol. 1993;137:383–92.

    PubMed  Google Scholar 

  53. Akahoshi M, Soda M, Nakashima E, et al. Effects of menopause on trends of serum cholesterol, blood pressure, and body mass index. Circulation. 1996;94:61–6.

    Article  CAS  PubMed  Google Scholar 

  54. Campos H, McNamara JR, Wilson PW, et al. Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal women. J Clin Endocrinol Metab. 1988;67:30–5.

    Article  CAS  PubMed  Google Scholar 

  55. Matthews KA, Wing RR, Kuller LH, et al. Influence of the perimenopause on cardiovascular risk factors and symptoms of middle-aged healthy women. Arch Intern Med. 1994;154:2349–55.

    Article  CAS  PubMed  Google Scholar 

  56. Tsuda M, Sanada M, Nakagawa H, et al. Phenotype of apolipoprotein E influences the lipid metabolic response of postmenopausal women to hormone replacement therapy. Maturitas. 2001;38:297–304.

    Article  CAS  PubMed  Google Scholar 

  57. Godsland IF. Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974–2000. Fertil Steril. 2001;75:898–915.

    Article  CAS  PubMed  Google Scholar 

  58. The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA. 1995;273:199–208.

  59. Ory SJ, Field CS, Herrmann RR, et al. Effects of long-term transdermal administration of estradiol on serum lipids. Mayo Clin Proc. 1998;73:735–8.

    Article  CAS  PubMed  Google Scholar 

  60. Alexandersen P, Haarbo J, Christiansen C. Impact of combined hormone replacement therapy on serum lipid metabolism: new aspects. Gynecol Endocrinol. 1997;11:281–8.

    Article  CAS  PubMed  Google Scholar 

  61. Wakatsuki A, Ikenoue N, Okatani Y, et al. Estrogen-induced small low density lipoprotein particles may be atherogenic in postmenopausal women. J Am Coll Cardiol. 2001;37:425–30.

    Article  CAS  PubMed  Google Scholar 

  62. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association. Circulation. 2011;123:1243–62. These guidelines provide evidence for control of major CV risk factors in women and encourage application of effective therapies; a new concept of “Ideal Cardiovascular Health” is introduced.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Anderson KM, Castelli WP, Levy D. Cholesterol and mortality. 30 years of follow-up from the Framingham study. JAMA. 1987;257:2176–80.

    Article  CAS  PubMed  Google Scholar 

  64. Sharrett AR, Ballantyne CM, Coady SA, et al. Atherosclerosis Risk in Communities Study Group. Coronary heart disease prediction from lipoprotein cholesterol levels, triglycerides, lipoprotein (a), apolipoproteins A-I and B, and HDL density subfractions: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2001;104:1108–13.

    Article  CAS  PubMed  Google Scholar 

  65. Law MR, Wald NJ, Thompson SG. By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ. 1994;308:367–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  66. Brunner D, Weisbort J, Meshulam N, et al. Relation of serum total cholesterol and high-density lipoprotein cholesterol percentage to the incidence of definite coronary events: twenty-year follow-up of the Donolo-Tel Aviv Prospective Coronary Artery Disease Study. Am J Cardiol. 1987;59:1271–6.

    Article  CAS  PubMed  Google Scholar 

  67. Gordon DJ, Probstfield JL, Garrison RJ, et al. High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation. 1989;79:8–15.

    Article  CAS  PubMed  Google Scholar 

  68. Cooney MT, Dudina A, De Bacquer D, Fitzgerald A, Conroy R, Sans S, et al. Graham I; SCORE Investigators. How much does HDL cholesterol add to risk estimation? A report from the SCORE Investigators. Eur J Cardiovasc Prev Rehabil. 2009;16:304–14.

    Article  PubMed  Google Scholar 

  69. Hokanson JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk. 1996;3:213–9.

    Article  CAS  PubMed  Google Scholar 

  70. Bansal S, Buring JE, Rifai N, et al. Fasting compared with nonfasting triglycerides and risk of cardiovascular events in women. JAMA. 2007;298:309–16.

    Article  CAS  PubMed  Google Scholar 

  71. Kamigaki AS, Siscovick DS, Schwartz SM, et al. Low density lipoprotein particle size and risk of early-onset myocardial infarction in women. Am J Epidemiol. 2001;153:939–45.

    Article  CAS  PubMed  Google Scholar 

  72. Mykkänen L, Kuusisto J, Haffner SM, et al. LDL size and risk of coronary heart disease in elderly men and women. Arterioscler Thromb Vasc Biol. 1999;19:2742–8.

    Article  PubMed  Google Scholar 

  73. Bostom AG, Gagnon DR, Cupples LA, et al. A prospective investigation of elevated lipoprotein (a) detected by electrophoresis and cardiovascular disease in women. The Framingham Heart Study. Circulation. 1994;90:1688–95.

    Article  CAS  PubMed  Google Scholar 

  74. Prospective Studies Collaboration, Lewington S, Whitlock G, Clarke R, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007;370:1829–39.

    Article  Google Scholar 

  75. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–78.

    Article  CAS  PubMed  Google Scholar 

  76. Frick MH, Elo O, Haapa K, et al. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med. 1987;317:1237–45.

    Article  CAS  PubMed  Google Scholar 

  77. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Engl J Med. 1998;339:1349–57.

  78. Ornish D, Scherwitz LW, Billings JH, et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998;280:2001–7.

    Article  CAS  PubMed  Google Scholar 

  79. Estruch R, Ros E, Salas-Salvadó J, et al. PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–90. A multicenter randomized trial conducted in Spain, enrolling 7447 persons to test the efficacy of two types of Mediterranean diet (one supplemented with extra-virgin olive oil and another with nuts), as compared with a control diet in primary cardiovascular prevention.

    Article  CAS  PubMed  Google Scholar 

  80. Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s health initiative randomized controlled dietary modification trial. JAMA. 2006;295:655–66.

    Article  CAS  PubMed  Google Scholar 

  81. Chomistek AK, Chiuve SE, Eliassen AH, Mukamal KJ, Willett WC, Rimm EB. Healthy lifestyle in the primordial prevention of cardiovascular disease among young women. J Am Coll Cardiol. 2015;65:43–51.

    Article  PubMed  Google Scholar 

  82. Cholesterol Treatment Trialists’ (CTT) Collaborators, Kearney PM, Blackwell L, Collins R, et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008;371:117–25.

    Article  Google Scholar 

  83. Kizer JR, Madias C, Wilner B, et al. Relation of different measures of low-density lipoprotein cholesterol to risk of coronary artery disease and death in a meta-regression analysis of large-scale trials of statin therapy. Am J Cardiol. 2010;105:1289–96.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  84. Amarenco P, Labreuche J, Lavallée P, et al. Statins in stroke prevention and carotid atherosclerosis: systematic review and up-to-date meta-analysis. Stroke. 2004;35:2902–9.

    Article  CAS  PubMed  Google Scholar 

  85. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670–81.

    Article  Google Scholar 

  86. Brugts JJ, Yetgin T, Hoeks SE, et al. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ. 2009;338:b2376.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  87. Petretta M, Costanzo P, Perrone-Filardi P, et al. Impact of gender in primary prevention of coronary heart disease with statin therapy: a meta-analysis. Int J Cardiol. 2010;138:25–31.

    Article  PubMed  Google Scholar 

  88. Kostis WJ, Cheng JQ, Dobrzynski JM, et al. Meta-analysis of statin effects in women versus men. J Am Coll Cardiol. 2012;59:572–82. A meta-analysis of sex-specific outcomes in controlled randomized trials of statin therapy.

    Article  CAS  PubMed  Google Scholar 

  89. Virani SS, Woodard LD, Ramsey DJ, et al. Gender disparities in evidence-based statin therapy in patients with cardiovascular disease. Am J Cardiol. 2015;115:21–6. The paper contains of US national cohort of 972,532 patients with CVD treated in 130 Veterans Health Administration facilities, analyzing the proportion of females receiving any statin and high-intensity statin.

    Article  PubMed  Google Scholar 

  90. The Lipid Research Clinics Coronary Primary Prevention Trial results. I. Reduction in incidence of coronary heart disease. No authors listed. JAMA. 1984;251:351–64.

  91. Robins SJ, Collins D, Wittes JT, et al. VA-HIT study group. Veterans affairs high-density lipoprotein intervention trial. Relation of gemfibrozil treatment and lipid levels with major coronary events: VA-HIT: a randomized controlled trial. JAMA. 2001;285:1585–91.

    Article  CAS  PubMed  Google Scholar 

  92. Keech A, Simes RJ, Barter P, et al. FIELD study investigators. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366:1849–61.

    Article  CAS  PubMed  Google Scholar 

  93. ACCORD Study Group, Ginsberg HN, Elam MB, Lovato LC, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010;362:1563–74.

    Article  Google Scholar 

  94. AIM-HIGH Investigators, Boden WE, Probstfield JL, Anderson T, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011;365:2255–67.

    Article  Google Scholar 

  95. Blazing MA, Giugliano RP, Cannon CP, et al. Evaluating cardiovascular event reduction with ezetimibe as an adjunct to simvastatin in 18,144 patients after acute coronary syndromes: final baseline characteristics of the IMPROVE-IT study population. Am Heart J. 2014;168:205–12. This paper provides final baseline characteristics of 18,144 patients with acute coronary syndrome randomized either to 40 mg of simvastatin and 10 mg of ezetimibe or placebo.

    Article  CAS  PubMed  Google Scholar 

  96. Kohno T. Report of the American Heart Association (AHA) Scientific Sessions 2014, Chicago. Circ J. 2015;79:34–40. This is a brief report from the 2014 AHA Scientific Sessions; currently the only printed report on the IMPROVE-IT study.

  97. Ray KK, Kastelein JJ, Boekholdt SM, et al. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011. Eur Heart J. 2014;35:960–8. This paper discusses the potential implications of adopting the ACC/AHA guidelines on patient care in Europe and beyond, and concludes with the opinion that the 2011 ESC/EAS guidelines seems to be the most wide-ranging, pragmatic and appropriate choice for European countries.

    Article  PubMed  Google Scholar 

  98. Duntas LH. Thyroid disease and lipids. Thyroid. 2002;12:287–93.

    Article  CAS  PubMed  Google Scholar 

  99. Kusters DM, Hassani Lahsinoui H, van de Post JA, et al. Statin use during pregnancy: a systematic review and meta-analysis. Expert Rev Cardiovasc Ther. 2012;10:363–78. This is a systematic review of both human and animal studies on the teratogenic effects of statins during pregnancy; the available data suggest statins are unlikely to be teratogenic.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This review was partly supported by grant NT 12102–4 awarded by the Internal Grant Agency of the Ministry of Health of the Czech Republic.

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Renata Cífková and Alena Krajčoviechová declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Videnska 800, 140 59, Prague 4, Czech Republic

    Renata Cífková & Alena Krajčoviechová

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  1. Renata Cífková
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  2. Alena Krajčoviechová
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Correspondence to Renata Cífková.

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This article is part of the Topical Collection on Lipid Abnormalities and Cardiovascular Prevention

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Cífková, R., Krajčoviechová, A. Dyslipidemia and Cardiovascular Disease in Women. Curr Cardiol Rep 17, 52 (2015). https://doi.org/10.1007/s11886-015-0609-5

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