Statins for primary prevention of cardiovascular mortality in women: a systematic review and meta-analysis.

The benefits of statins on prevention of coronary heart disease in women without heart disease have not been clarified. The authors systematically reviewed all the published literature on primary prevention trials and found 6 primary prevention trials to date with sex-specific data on mortality and coronary heart disease events in women. The summary risk ratio for primary prevention of all-cause mortality was 0.90 (95% confidence interval, 0.60-1.35; P=.61) and for any coronary heart disease event was 0.78 (95% confidence interval, 0.64-0.96; P=.02). This review reveals that statin therapy along with diet and exercise in moderately hyperlipidemic women without a previous history of cardiovascular disease is of significant benefit in preventing coronary heart disease events but of no proven benefit in preventing all-cause mortality.

Postprandial metabolic responses to dietary glycemic index in hypercholesterolemic postmenopausal women.

Cardiovascular disease is the leading cause of death in postmenopausal women. While diet and lifestyle remain the cornerstones of prevention, a low-fat/high-carbohydrate diet is associated with hyperglycemia and hyperlipemia-atherosclerotic risk factors affected by postprandial conditions. The objective of this study was to examine the acute response of lipids and insulin to a low-fat/high-carbohydrate meal with either a high-glycemic or a low-glycemic index in healthy postmenopausal women. Fifteen healthy postmenopausal women were enrolled in a randomized crossover dietary intervention study. Levels of glucose, triglyceride, free fatty acids (FFAs), and insulin were measured preprandially and for 240 minutes after consumption of the test meals. In response to the high-glycemic compared with the low-glycemic index meal, postprandial insulin levels had a higher peak (65.4 vs 48.1 microU/mL, respectively), the homeostasis model assessment-insulin resistance (HOMA-IR) was significantly higher (P=.014), serum triglyceride levels declined significantly (P<.001), and there was a small reduction in FFA levels, although the difference did not reach statistical significance. The results suggest a postprandial impact of glycemic index on cardiovascular metabolic biomarkers in postmenopausal women and may have implications for dietary glycemic modification of cardiovascular risk in women.