Women and Lipids

Women and Lipids

There are currently no sex-specific guidelines for the evaluation and management of lipids.

  • Lipids are impacted by normal hormonal changes in women throughout their life cycle.
  • Management of lipids should incorporate sex-specific CV risk-factors.
  • Future trials should focus on increasing women’s participation in trials of lipid-lowering therapies.

Primary prevention in women

  • Statins are indicated in women with ASCVD risk >7.5%.
  • Risk enhancing factors include autoimmune diseases, hormones, gestational issues, family history.
  • Radiation or chemotherapies for breast cancer are added risk.
  • CRP and calcium scores are helpful in risk stratification.

Nonstatin treatment for LDL

  • IMPROVE-IT trial: Simvastatin + ezetimibe OR 0.88 in women vs. 0.9 in men.
  • FOURIER trial: Evalocumab + statin OR 0.81 in women vs. 0.86 for men.
  • ODYSSEY trial: Similar benefits in women.
  • Bempedoic acid: Similar benefits in women.
  • REDUCE-IT trial: Icosapent ethyl, an EPA-only omega-3 fatty acid, reduced events with similar benefits in men and women.
  • Fibrates-FIELD: Greater benefit in women in reduction of nonfatal MI and reduction in CV mortality, whereas ACCORD trial women had worse CV outcomes on fibrates compared to placebo.

Dr. Asha Mahilmaran

Dr. Asha Mahilmaran is a top Cardiologist working with Apollo Hospitals, Greams Road, Chennai. She is a gold-medalist in medicine and a member of Prestigious Organizations, including the Cardiology Society of India. She completed MBBS from Bharathiyar University in 1990. MD - (General Medicine) from The Tamil Nadu, Dr. M.G.R Medical University in 1993 and DM - (Cardiology) from The Tamil Nadu. Dr. M.G.R Medical University in 1999. She has Membership in Indian Medical Association (IMA), CSI, API.

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