Management of Dyslipidemia in Women in the Post–hormone Therapy Era

Authors


  • Dr. Mosca provides consulting services and/or serves on advisory boards/speakers' bureaus for the following companies: Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Eli Lilly Research Laboratories, Kos Pharmaceuticals, Merck-Schering Plough, Organon Inc., and Pfizer Inc. Dr. Mosca does not have stock in any companies that would be perceived as a conflict of interest.

Address correspondence and requests for reprints to Dr. Mosca: Preventive Cardiology Program, New York-Presbyterian Hospital, 622 West 168th Street, PH 10-203B, New York, NY 10032 (e-mail: ljm10@columbia.edu).

Abstract

Objective: Cardiovascular disease (CVD) is the leading cause of death for women in the United States and is largely preventable. The American Heart Association has recently released evidence-based guidelines for the prevention of CVD in women; these include gender-specific recommendations for the management of dyslipidemia. This article reviews these recommendations and the evidence supporting them.

Design: This was a qualitative review of a systematic literature search related to lipid guidelines for women and discussion of rationale and evidence for new clinical recommendations.

Main Results: Lifestyle modifications are the cornerstone of lipid management. Substantial evidence from randomized clinical trials supports the use of low-density lipoprotein cholesterol–lowering therapy (primarily statins) in all high-risk women and the use of niacin or fibrates when high-density lipoprotein cholesterol is low or non-high-density lipoprotein cholesterol is elevated. Fewer data are available for women at lower or intermediate risk.

Conclusions: Encouragement of lifestyle modification and appropriate use of lipid-altering therapy will have a substantial impact on reducing the burden of cardiovascular disease in women.

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