Life-Saving Cholesterol Medication May Be Underprescribed in Women
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 changes.
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 LDL levels.
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.