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Challenges in Optimizing Lipid Management in Women

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Abstract

While there are physiologic differences in lipid metabolism in men and women, pharmacologic therapy is very effective in both with similar management strategies recommended in the current guidelines for the management of dyslipidemia. Despite similar guidelines for treatment, studies have shown that women have worse control of dyslipidemia than their male counterparts. This may stem from multiple contributing factors including underestimation of cardiovascular disease risk in women, decreased prescription and utilization of lipid-lowering therapies, decreased medication adherence, and higher risk of statin intolerance, all of which may contribute to lower attainment of lipid targets. Furthermore, heart disease is the leading cause of mortality in women, with heart disease noted an average of 7–10 years later than in men. This has historically led to the misperception that women are protected from heart disease and can be treated less aggressively. In fact, traditional risk factors for atherosclerotic cardiovascular disease often impact risk in women to a greater extent than they do in men. Unique risk factors such as pregnancy-related disorders also contribute to the level of risk and therefore warrant consideration in risk stratification. This review summarizes the efficacy of contemporary lipid-lowering therapies in women versus men and discusses the challenges that arise with lipid management in women along with potential ways to tackle these obstacles.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Albany Medical College and Albany Medical Center, 47 New Scotland Ave, Albany, NY, 12208, USA

    Kellsey A. Peterson, Gurleen Kaur, Sulagna Mookherjee, Kim A. Poli, Mandeep S. Sidhu & Radmila Lyubarova

  2. Department of Cardiology, Lenox Hill Hospital, Northwell Health, New York, NY, USA

    Eugenia Gianos

  3. Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA

    Eugenia Gianos

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  1. Kellsey A. Peterson
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  2. Gurleen Kaur
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  4. Sulagna Mookherjee
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Correspondence to Radmila Lyubarova.

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Competing Interests

Dr. Sidhu reports Scientific Advisory Board service Astra Zeneca in 2019 & Sanofi-Regeneron in 2019. Dr. Gianos reports Educational Grant from Astra Zeneca (diabetes initiative), site principal investigator for HERITAGE and HORISON trials from Novartis, and VESALIUS trial from Amgen; non-promotional speaker honorarium from Kaneka (lipid-lowering medications).

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Peterson, K.A., Kaur, G., Gianos, E. et al. Challenges in Optimizing Lipid Management in Women. Cardiovasc Drugs Ther 36, 1197–1220 (2022). https://doi.org/10.1007/s10557-021-07273-0

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