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Statin therapy, cardiovascular events, and total mortality in the Heart and Estrogen/Progestin Replacement Study

David M Herrington1, Eric Vittinghoff, Feng Lin

  • 1Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. dherring@wfubmc.edu

Circulation
|June 26, 2002
PubMed

Insights

Statin use in postmenopausal women with heart disease significantly lowered cardiovascular events, venous thromboembolic events, and total mortality. These findings support statin therapy for eligible women with coronary disease.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Women's Health

Background:

  • Cardiovascular outcomes of statins are established in men, but less so in women.
  • The combined effects of statins and hormone replacement therapy (HRT) on cardiovascular outcomes remain uncertain.

Purpose of the Study:

  • To examine the effects of statin use on cardiovascular events and mortality in postmenopausal women with heart disease.
  • To investigate the interaction between statin use and hormone replacement therapy (HRT) on cardiovascular outcomes.

Main Methods:

  • Analysis of data from the Heart and Estrogen/progestin Replacement Study (HERS), a randomized clinical trial.
  • Nonrandomized comparison of statin users versus nonusers among 2763 postmenopausal women with heart disease.

Main Results:

  • Statin users had lower rates of the primary outcome (nonfatal myocardial infarction or coronary heart disease death) (RH=0.79, P=0.04).
  • Statin use was associated with significantly lower total mortality (RH=0.67, P=0.003) and venous thromboembolic events (RH=0.45, P=0.02).
  • Hormone replacement therapy (HRT) increased early risk for primary events in non-statin users, but not in statin users; adjusted analysis showed no effect of HRT on the primary outcome.

Conclusions:

  • Statin use in postmenopausal women with coronary disease is linked to reduced cardiovascular events, venous thromboembolic events, and overall mortality.
  • These findings strongly support the use of statins in eligible women with existing coronary disease.
Abstract

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