Life-Saving Cholesterol Medication May Be Underprescribed in Women
WebMD News Archive
Feb. 14, 2000 (Minneapolis) -- A new study shows that despite the fact that
cholesterol-lowering medications can lower the risk of heart attacks and death
in people with heart disease, many physicians at major teaching hospitals still
do not prescribe them. The study, undertaken by researchers from several
leading universities, also found that significantly fewer women than men with
heart disease are receiving any medication at all. The study was published in
the Feb. 14 issue of the Archives of Internal Medicine.
"In general, treatment rates for patients with a history of heart
disease were far too low, but the lack of adequate treatment in women was
particularly worrisome," writes lead author Michael Miller, MD, director of
preventive cardiology at the University of Maryland Medical Center and
colleagues from elsewhere. "These results provide evidence of considerable
sex bias in the treatment of women with heart disease at major academic medical
centers." Miller is also associate professor of medicine at the University
of Maryland School of Medicine.
The study investigated the use of cholesterol-lowering medications in more
than 800 men and women with heart disease at 16 academic medical centers in the
U.S. and Canada. Twenty percent of the study participants were women.
Researchers found that about half of the patients had dangerously high levels
of LDL, the "bad" form of cholesterol, above 130 mg/dL.
According to the National Cholesterol Education Program guidelines, the LDL
goal in heart disease patients should be below 100 mg/dL. Patients with an LDL
that exceeds 130 mg/dL will generally require medication, as will people who
continue to have an LDL greater than 100 mg/dL even after making dietary
Researchers found that in 1994, a little more than one-third of women and
men with high LDL were receiving cholesterol-lowering medication. By 1997,
however, more than half of the men were receiving medication, while only
one-third of women were receiving drug therapy. Not surprising, scientists also
learned that women were much less successful than men in reaching acceptable
Researchers did not know why women were so under-treated compared to men,
especially since the extent of heart disease was similar in both groups.
"We have great knowledge and proven therapies to reduce the risk of
first and second [heart attacks]," Miller tells WebMD. "We also have
great [study results] to show that we can reduce the risk of heart disease.
[Now,] we need to take better advantage of these [resources.]"
Other experts say that patients also need to take responsibility for their
health. Dick Karas, MD, PhD, director of the Women's Heart Center at New
England Medical Center in Boston, says it's important for patients to know
their cholesterol levels and keep track of changes. "Ask your doctor what
it is, and write it down," he tells WebMD.