Prevención Primaria de problemas cardiovasculares en mujeres

En la última revision sobre la PREVENCIÓN DE LA ENFERMEDAD CARDIOVASCULAR EN LA MUJER POSTMENOPAÚSICA, Mosca y colaboradores hacen una exclente esposición sobre la misma y en las Intervenciones sobre el estilo de vida,  basadas en medicina basada en la evidencia, sólo se mencionan tabaquismo, actividad física, rehabilitación, dieta, mantenimiento/reducción de peso, uso de Omega-3 y consideraciones sobre la depresión ( 1 ), por lo que el articulo siguiente debe de ser una llamada de atención a lo que podríamos tener en el futuro.Además les recomiendo dar una revisión del tema en este mismo blog en Enero del 2009.

1-     Mosca L, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation 2007, doi:10.1161/CIRCULATIONAHA.107.181546 Published online before print February 19, 2007

Statins for the Primary Prevention of Cardiovascular Events in Women With Elevated High-Sensitivity C-ReactiveProtein or Dyslipidemia Results From the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and Meta-Analysisof Women From Primary Prevention Trials

Samia Mora, MD, MHS; Robert J. Glynn, ScD; Judith Hsia, MD; Jean G. MacFadyen, BA;Jacques Genest, MD; Paul M Ridker, MD, MPH

Background—Statin therapy in women without cardiovascular disease (CVD) is controversial, given the insufficient evidence of benefit. We analyzed sex-specific outcomes in the Justification for the Use of Statins in Prevention: AnIntervention Trial Evaluating Rosuvastatin (JUPITER) and synthesized the results with prior trials.

Methods and Results—JUPITER participants included 6801 women >60 years of age and 11 001 men >50 years of agewith high-sensitivity C-reactive protein >2 mg/L and low-density lipoprotein cholesterol <130 mg/dL randomized torosuvastatin versus placebo. Meta-analysis studies were randomized placebo-controlled statin trials with predominantly or exclusively primary prevention in women and sex-specific outcomes (20 147 women; >276 CVD events; mean age,63 to 69 years). Absolute CVD rates (per 100 person-years) in JUPITER women for rosuvastatin and placebo (0.57 and1.04, respectively) were lower than for men (0.88 and 1.54, respectively), with similar relative risk reduction in women (hazard ratio, 0.54; 95% confidence interval, 0.37 to 0.80; P<0.002) and men (hazard ratio, 0.58; 95% confidence interval, 0.45 to 0.73; P<0.001). In women, there was significant reduction in revascularization/unstable angina and nonsignificant reductions in other components of the primary end point. Meta-analysis of 13 154 women (240 CVDevents; 216 total deaths) from exclusively primary prevention trials found a significant reduction in primary CVD events with statins by a third (relative risk, 0.63; 95% confidence interval, 0.49 to 0.82; P0.001; P for heterogeneity 0.56)with a smaller nonsignificant effect on total mortality (relative risk, 0.78; 95% confidence interval, 0.53 to 1.15; P 0.21;P for heterogeneity 0.20). Similar results were obtained for trials that were predominantly but not exclusively primary prevention.

Conclusion—JUPITER demonstrated that in primary prevention rosuvastatin reduced CVD events in women with a relative risk reduction similar to that in men, a finding supported by meta-analysis of primary prevention statin trials. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00239681.

-          Circulation. 2010;121:1069-1077