Statin Initiation Should be Guided by Age, Sex

Expert panel to decide whether prescribing information on testosterone drugs should be changed.
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(HealthDay News) -- Use of age- and sex-specific cardiovascular disease (CVD) risk thresholds could improve the sensitivity and specificity of statin treatment recommendations, according to a study published in the Journal of the American College of Cardiology.

Ann Marie Navar-Boggan, M.D., Ph.D., from the Duke University Medical Center in Durham, N.C., and colleagues examined the potential impact of incorporating age- and sex-specific CVD risk thresholds into current cholesterol guidelines. Data were included from the Framingham Offspring Study for 3,685 participants free of CVD.

The researchers found that basing statin recommendations on a 10-year fixed risk threshold of 7.5% resulted in lower statin consideration for women (33%) than men (63%; P < 0.0001); however, statins were recommended for most study participants aged 66 to 75 years (90.3%). 

In younger men and women (aged 40 to 55 years), the fixed 7.5% threshold had relatively low sensitivity for capturing 10-year events. When the treatment threshold was reduced to 5% in participants aged 40 to 55 years, the sensitivity of the recommendations was improved substantially. Specificity was poor among older adults (aged 66 to 75 years) but it improved significantly when the treatment threshold was raised to 10% in women and 15% in men, with minimal loss in sensitivity.

"Cholesterol treatment recommendations could be improved by using individualized age- and sex-specific CVD risk thresholds," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

Sources

  1. Navar-Boggan, AN, et al. J Am Coll Cardiol. 2015;65(16):1633-1639; doi:10.1016/j.jacc.2015.02.025.
  2. Neil J. Stone, MD. J Am Coll Cardiol. 2015;65(16):1640-1643; doi:10.1016/j.jacc.2015.02.041.
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