06/09/2008 11:46 am ET Updated Nov 17, 2011

Should I Give My Wife a Statin?

I shall wear white flannel trousers and walk upon the beach.

You may have read that heart disease is under diagnosed in women, and that they are missing potential treatments that could save their lives. For instance, a couple of years ago Newsweek reported that heart disease is a "grave threat to women's health, but no one needs to take it lying down. Statin drugs (Zocor, Lipitor, Pravachol and others) can slash a woman's heart-attack risk by more than a third--just as they do in men... should you be taking one of these medications?"

The answer is--probably not. Just because your cholesterol is high, and statins reduce it, doesn't mean it will prevent heart attacks or death in women without a history of heart disease. In the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALL-HAT), a large study funded by the government that received no drug company support, LDL cholesterol came down with statins, but there was no reduction in mortality. In a study that combined all of the available information on women from different clinical trials, the authors found no reduction in heart attacks or mortality in women with high cholesterol who did not have a history of heart disease. That means that if you are a woman with high cholesterol who does not have a history of heart disease, and you don't have familial hypercholesterolemia, you won't benefit from taking a statin.

Even if you are a woman with a history of heart disease statins might prevent more heart attacks but they won't necessarily save your life. For example, although the Heart Protection Study showed a reduction in heart attacks (with no reduction in mortality), more studies, including ASCOT, LIPID, and PROSPER, did not. The Scandinavian Simvastatin Survival Study (4S) found a 12% increase in overall mortality for women, even though there was a 24% reduction in heart disease related mortality. The Cholesterol And Recurrent Events (CARE) study showed an increase in breast cancer in women, which may explain the increased overall mortality in spite of the reduced cardiac mortality.

Bottom line is for women (or mermaids) without heart disease or familial hypercholesterolemia there is no proven benefit to taking statins. And a lot of people don't know it but for women with heart disease doing things like adopting the Mediterranean Diet (vegetables, nuts, fish, etc.) and exercising cuts heart disease by more than 50%-- a result that is twice as good as medications!

So J. Alfred, don't just walk down the beach. Run!

Doug Bremner MD is author of Before You Take That Pill: Why the Drug Industry May be Bad for Your Health: Risks and Side Effects You Won't Find on the Label of Commonly Prescribed Drugs, Vitamins, and Supplements