Cardiovascular prevention in women with dyslipidemia

In both men and women, cardiovascular disease remains an important cause of premature mortality. In women, primary prevention of cardiovascular disease should include lifestyle change measures with proven benefits, such as avoiding obesity and physical inactivity. Statins have proven benefits for cardiovascular prevention. Despite advances in the treatment of cardiovascular disease, women remain underdiagnosed and undertreated, leading to a higher rate of hospitalization and death from cardiovascular disease. Obesity, more common among women with age, increases the risk of metabolic syndrome and cardiovascular disease. There are gender differences in the screening, diagnosis and treatment of dyslipidaemia, with women receiving statins less often and in lower doses, even after a myocardial infarction. Real-life data show that women are at greater risk for statin non-adherence compared to men and are more likely to discontinue treatment due to side effects. Women show some particularities in the metabolism of statins, due to the lower glomerular filtration rate, the higher percentage of adipose tissue, the faster metabolism of statins compared to men. In women of childbearing age, the use of contraceptives should be discussed when statin treatment is initiated, given the possible teratogenic effect. Elderly women are more at risk of polypharmacy and drug and food interactions, and drugs associated with statins should be rigorously evaluated.