02/06/2025
Dr. Thomas J. Lewis
Dec 26, 2023
Updated: Dec 28, 2023
Women and Statin Drugs
From the book, "Health Freedom Lost."
Far too many healthy people are coerced into taking statins and women top the list. A significant amount of research indicates the drugs will do them little good and may be more likely to cause serious side effects in women.
“If you’re going to tell a healthy person to take a medicine every day for the rest of their life, you should have really good data that it’s going to make them better off,” said Dr. Rita Redberg, a cardiologist at the University of California, San Francisco, and the former editor of JAMA Internal Medicine. Lowering cholesterol should not be an end in itself, she stated, “You can have high cholesterol and still be really healthy and have a low risk of heart disease,” she said.
Although women represent slightly more than half of the population, they have been vastly underrepresented in clinical trials of statins. As a result, evidence of the benefits and risks for women is limited. Women develop heart disease about 10 years later in life on average than men.
Studies have found that healthy women who took statins to prevent cardiovascular disease did experience fewer episodes of chest pain and had fewer treatments like stents and bypass surgery. But statins did NOT prevent healthy women from having their first heart attacks and did NOT save lives. The Jupiter trial, which included 6,801 women age 60 and older, found a lower risk of hospitalization for unstable angina, but that was the only real benefit.[i]
The absolute number of these adverse health issues was tiny, and there was no reduction in heart attacks, strokes, and deaths in women. “The data are underwhelming, to say the least,” said Dr. Barbara Roberts, author of “The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs” and an associate professor of medicine at Brown University. “Women who are healthy derive no benefit from statins. I have women come to me who were put on statins in their 30s by their physician because their cholesterol was a point or two above what’s said to be normal,” Dr. Roberts said. “This is insane.”
But Dr. Roberts advises women that they can reduce their heart risk by watching their weight, exercising, and following a diet rich in fish, fruits and vegetables, nuts, and olive oil — and, if they’ve never had heart trouble, forgetting statins. “We know you can get the benefit and relative risk reduction from adhering to a Mediterranean-style diet,” she said.
Medscape produced an article titled, "Statins, Cholesterol, Women, and Primary Prevention: Evidence-Based Medicine or Wishful Thinking?"[ii] Their summary is provided here.
"A basic tenet of modern cardiology is that elevated cholesterol increases the risk of myocardial infarction (MI - a heart attack). Significantly lowering cholesterol should, therefore, reduce MI risk. Statins reduce cholesterol and, in some contexts, adverse heart outcomes, but meta-analyses of primary prevention clinical statin trials have found no statistically significant cardioprotective effect for women. These meta-analyses reasonably reflect the individual primary prevention trials."
"Of these studies, none showed statistically significant cardioprotection for women and some yielded hazard ratios exceeding one meaning they had worse outcomes compared to no treatment. The meta-analyses are consistent with the absence of effect for women in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), atorvastatin's (Lipitor®) primary prevention clinical trial, and are also consistent with the unpublished Carotid Atorvastatin Study in Hyperlipidemic Postmenopausal Women (CASHMERE) atorvastatin clinical trial, which demonstrated no improvement in carotid intima-media thickening (IMT) in a study limited to postmenopausal women."
"The cholesterol-heart attack link and the achievement of lowered cholesterol without protective effect is an important scientific puzzle."
There is really no puzzle. Lowering LDL, thus total cholesterol is not the proper target to prevent heart disease.
[i] Kostapanos, Michael S., and Moses S. Elisaf. "JUPITER and satellites: Clinical implications of the JUPITER study and its secondary analyses." World Journal of Cardiology 3.7 (2011): 207.
[ii] https://www.medscape.com/viewarticle/587563. April 18, 2022.
