Clarification of Answer by
crabcakes-ga
on
08 Jan 2005 13:07 PST
Hello again ghost1234,
I'm afraid that the best figure I can find is that a healthy woman
with no changeable risk factors has a five times lower risk of heart
disease than unhealthy women.
?If you smoke, have high blood pressure, and also have high blood
cholesterol, your risk to five times higher than that of women who
have no risk factors.?
?Also, after menopause, women are more apt to get cardiovascular
diseases, in part because their bodies produce less estrogen. Women
who have had early menopause, either naturally or because their
ovaries have been surgically removed, are twice as likely to develop
coronary heart disease as women of the same age who have not begun
menopause.
While any one risk factor will raise your chances of developing or
worsening heart-related problems, the more risk factors you have, the
more concerned you should be about prevention?
http://www.pueblo.gsa.gov/cic_text/health/healthy-heart/aheart.htm
I have found no studies comparing mortality rates in women (of any
age) with no known risk factors and those with one to several. It
appears that having high cholesterol and being over 65 are two risk
factors in themselves. Obviously, women who smoke, overeat, avoid
exercise, and have high cholesterol are at a much greater risk. A
figure other than these women have a 5 times greater chance of heart
disease is the best I was able to find, after an exhaustive search, I
have found that the side effects of statins to be low, while
beneficial, seemingly protecting against not only heart disease, but
possibly breast cancer and osteoporosis. (Information on statins is
found near the bottom of this answer)
According to this Ohio Department of Health site, ALL women over 64
face an increased risk of heart disease. Risk factors certainly
increase the chance of heart disease, but even apparently healthy
women have a greater risk, just by being over 65. Add a high
cholesterol, a low HDL, a high LDL and you have risk factors.
?Age is a significant factor in heart disease and cerebrovascular
disease mortality. The heart disease mortality rate for all women over
the age of 65 is twelve times that of women ages 45 to 64. The rate
for cerebrovascular disease is nearly seven times higher for people
over age 85 than for those ages 65 to 84.?
http://www.odh.state.oh.us/Data/Womendata/book3/card.htm
?According to the new recommendations, the aggressiveness of treatment
should be linked to whether a woman has low, intermediate or high risk
of having a heart attack in the next 10 years, based on a standardized
scoring method developed by the Framingham Heart Study. ?This
provides a very individual approach to preventing CVD throughout the
population,? Mosca said.?
http://www.americanheart.org/presenter.jhtml?identifier=3018804
Women may have unknown risk factors, with no symptoms, such as
atherosclerosis (Hardening of the arteries), and that lowering
cholesterol is very important.
?? Most women over age 65 have obvious heart disease or "silent"
atherosclerosis ("hardening of the arteries"). In silent
atherosclerosis, there are no symptoms but fatty plaques have built up
in arteries. Lowering cholesterol is especially important to keep
heart disease and atherosclerosis from worsening.
? Each year, about 314,000 women aged 65 and older have a heart attack.
? The average age for women to have a first heart attack is about 70
-- and women are more likely than men to die within a few weeks of a
heart attack.?
http://www.intelihealth.com/IH/ihtIH/WSIHW000/8059/23585/375626.html?d=dmtContent
?You control all heart disease risk factors listed, except family
history, gender, and age.?
?The relatively few studies done on women indicate that it usually
strikes them after age 65, though certain factors may cause earlier
development, and that risk factors differ slightly for men and women.?
The following risk factors are known to contribute to both men and
women's chances of developing heart disease; the more factors, the
greater the risk.
?Elevated cholesterol, especially with elevated LDL and low HDL,
?Elevated triglycerides,
?Smoking,
?High blood pressure,
?Diabetes,
?Sedentary lifestyle,
?Obesity, especially where fat is concentrated above the waist,
?Stress,
?Family history of heart disease,
?Gender and age; risk starts earlier for men, increases for women post-menopause.
http://www.nutritionresource.com/article.cfm?ID=AR00011
If you have MS Power Point installed on your computer, you can see a
very interesting study of statins and women, on slides 22 and 38. I am
unable to give you an active link to this site, as pasting the URl
gives an error. If you go to this link,
://www.google.com/search?q=healthy+women+65+statins+-breast+-cancer&btnG=Search&hl=en&lr=&safe=active&c2coff=1
Scroll down to the middle of the page, and click on
[PPT] Beyond Cholesterol: Predicting Cardiovascular Risk In the 21st ...
You can view the Power Point. The HTML version does not display the graphics.
This was excerpted from one slide:
?Those who exercise, eat vegetarian diets, and consume alcohol have
lower levels. Exercise may also lower fibrinogen and plasma
viscosity. Studies also show statin-fibrate combinations
(simvastatin-ciprofibrate) and estrogen therapy to lower fibrinogen.?
?Research shows that for every 1% drop in the LDL cholesterol level,
the risk of a heart attack drops by 2%. Conversely, for every 1%
increase in HDL, the risk of a heart attack drops 3-4%.2
Therefore while one cholesterol reading is initially taken, the ratio
of HDL/LDL is equally as important and will be examined more closely
if cholesterol is high.?
http://www.fgb.com.au/Natural%20Rem%20Pages/Heart.htm
=======
Statins
=======
According to the American Heart Association:
The presence of other coronary heart disease risk factors influences
the use of cholesterol-lowering drugs:
?age (for men, 45 years or older; for women, 55 years or older OR
premature menopause)
?family history of premature CHD (a father, brother or son with a
history of CHD before age 55, OR a mother, sister or daughter with CHD
before age 65)
?smoking OR living or working every day with people who smoke
?high blood pressure (140/90 mm Hg or higher)
?HDL cholesterol less than 40 mg/dL
?diabetes (fasting blood sugar of 126 mg/dL or higher)
This indicates that having the following two risk factors: being a
woman over the age of 55 with too low of an HDL, may benefit from
statins.
?The drugs of first choice for elevated LDL cholesterol are the HMG
CoA reductase inhibitors, e.g., atorvastatin, fluvastatin, lovastatin,
pravastatin, rosuvastatin and simvastatin. Statin drugs are very
effective for lowering LDL cholesterol levels and have few immediate
short-term side effects.?
And
?Another class of drugs for lowering LDL is the bile acid sequestrants
? colesevelam, cholestyramine and colestipol ? and nicotinic acid
(niacin). These have been shown to reduce the risk for coronary heart
disease in controlled clinical trials. Both classes of drugs appear to
be free of serious side effects. But both can have troublesome side
effects and require considerable patient education to achieve
adherence. Nicotinic acid is preferred in patients with triglyceride
levels that exceed 250 mg/dL because bile acid sequestrants tend to
raise triglyceride levels.?
Other drugs for high cholesterol: ?Other available drugs are
gemfibrozil, probucol and clofibrate. Gemfibrozil and clofibrate are
most effective for lowering high triglyceride levels. They moderately
reduce LDL cholesterol levels in hypercholesterolemic patients, but
the FDA hasn't approved them for this purpose. Probucol also
moderately lowers LDL levels. It has FDA approval for this purpose.
If a patient doesn't respond adequately to single drug therapy,
combined drug therapy should be considered to further lower LDL
cholesterol levels. For patients with severe hypercholesterolemia,
combining a bile acid sequestrant with either nicotinic acid or
lovastatin has the potential to markedly lower LDL cholesterol. For
hypercholesterolemic patients with elevated triglycerides, nicotinic
acid or gemfibrozil should be considered as one agent for combined
therapy.?
http://www.americanheart.org/presenter.jhtml?identifier=4510
?Statins are the most effective and widely tested of cholesterol
drugs.1 Drug therapy can be considered for patients who ? in spite of
adequate dietary therapy, regular physical activity and weight loss ?
still need more treatment to manage their blood cholesterol levels.
Statins are also considered for patients with low or normal
cholesterol levels if they have established heart disease, or are at
risk for heart disease because of a clustering of other coronary heart
disease risk factors, including:
?Age ? If you are a man 45 years or older, or a woman 55 years or older.
?Family history ? Anyone with a mother, sister or daughter with
coronary heart disease before age 65; or with a father, brother or son
with a history of coronary heart disease before age 55.
?Smoking ? Anyone who smokes or who lives or works every day around
people who smoke.
?High blood pressure ? Anyone with a blood pressure of 140/90 mm Hg or
higher, measured on two or more occasions.
?HDL cholesterol ? For people whose HDL cholesterol level is less than 40 mg/dL.
?Diabetes ? Anyone with a fasting blood sugar of 126 mg/dL or higher.
?Statin drugs have few (<5 percent) immediate short-term or long-term
side effects and are considered as safe as aspirin therapy. The most
common side effects are muscle aches and pain. These symptoms are
usually mild-to-moderate and may subside as therapy continues. There
is a risk of 1 to 2 percent per year for developing abnormalities in
liver tests which is detected by routine blood test monitoring; these
are reversible when the drug is stopped or reduced.?
http://www.stlukesonline.org/WHA/resources/facts/statins.html
?Statins have consistently been shown in primary and secondary
prevention trials to be highly effective in treating dyslipidemia and
reducing the risk of cardiovascular events and are considered
first-line drug therapy. 3
As a class, statins are generally well tolerated. The most commonly
reported side effects are mild (such as gastrointestinal upset or
discolored urine); serious side effects are reported more rarely.3 The
major clinical concerns relating to statin therapy are myotoxicity
(myalgia, myopathy, and rhabdomyolysis) and hepatotoxicity, 4 which
generally occur secondary to excessive statin dosing or drug?drug
interactions that inhibit statin metabolism. Milder cases are often
reversible without serious clinical sequelae on drug discontinuation
or reduction of exposure; severe cases are rare but potentially
fatal.?
https://secure.pharmacytimes.com/lessons/200411-04.asp
?Statins have many benefits. In some people, they can reduce the risk
of heart attack and stroke. Like all medications, statins have
potential side effects. Although statins are well tolerated by most
people, the most common side effects are:
?Nausea
?Diarrhea
?Constipation
?Muscle aching
In addition, two potentially serious side effects are:
?Elevated liver enzymes. Occasionally, statin use causes an increase
in liver enzymes. If the increase is only mild, you can continue to
take the drug. If the increase is severe, you may need to stop taking
it, which usually reverses the problem. Certain other
cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin,
increase the risk of liver problems in people who take statins.
Because liver problems may develop without symptoms, people who take
statins should have their liver function tested periodically.
?Statin myopathy. Statins may cause muscle pain and tenderness (statin
myopathy). In severe cases, muscle cells can break down
(rhabdomyolysis) and release a protein called myoglobin into the
bloodstream. Myoglobin can impair kidney function and lead to kidney
failure. Certain drugs when taken with statins can increase the risk
of rhabdomyolysis. These include gemfibrozil, erythromycin
(Erythrocin), antifungal medications, nefazodone (Serzone),
cyclosporine and niacin. If you take statins and have new muscle
aching or tenderness, consult with your doctor.
Avoid taking statins with grapefruit juice, which alters your body's
metabolism of these drugs. Also, doctors generally recommend that
people take statins late in the day because the body makes most of its
cholesterol at night.?
http://www.mayoclinic.com/invoke.cfm?id=AN00587
?Statins have few important side effects. The most common side effects
are headache, nausea, vomiting, constipation, diarrhea, headache,
rash, weakness, and muscle pain. The most serious (but fortunately
rare) side effects are liver failure and rhabdomyolysis.
Rhabdomyolysis is a serious side effect in which there is damage to
muscles. Rhabdomyolysis often begins as muscle pain and can progress
to loss of muscle cells, kidney failure, and death. It occurs more
often when statins are used in combination with other drugs that
themselves cause rhabdomyolysis or with drugs that prevent the
elimination of statins and raise the levels of statins in the blood.
Since rhabdomyolysis may be fatal, unexplained joint or muscle pain
that occurs while taking statins should be brought to the attention of
a healthcare provider for evaluation.?
http://www.medicinenet.com/statins/page2.htm
"We must be really careful here. People currently only go on statins
if they meet the National Institutes of Health's criteria, that is,
their cholesterol's are already so high that they need medication to
lower them. There is no data about what would happen if people who had
normal cholesterol would take statins. Anyone who does meet elevated
cholesterol criteria for taking statins should be taking them already,
unless they have a medical contraindication."
?Steven T. DeKosky, M.D., Director, Alzheimer's Disease Research
Center, University of Pittsburgh
http://preventdisease.com/news/articles/cholesterol_memory.shtml
?An elevated total cholesterol to HDL-C ratio is a major risk factor
for CHD in women as well as men. Women respond well to lipid lowering
strategies (which include a lower fat diet and regular moderate
exercise). In fact, despite that fact that women generally have a
poorer prognosis following a heart attack or in response to
interventions such as coronary artery bypass grafting (CABG), women
appear to have a response to intensive lipid-lowering therapy which is
as good as or better than that of men.?
http://www.peakperformance.on.ca/health/1women_CHD.htm
You?ll probably need to sign up for a free membership in order to read
these entire articles:
Coronary Heart Disease Risk Reduction in Postmenopausal Women: The
Role of Statin Therapy and Hormone Replacement Therapy
?Statins are recommended as first-line treatment for lowering
low-density lipoprotein cholesterol levels in women and are extremely
valuable in reducing coronary heart disease risk in this group. An
awareness of the benefits of appropriate statin treatment, and
evidence showing that they can be safely added to hormone replacement
therapy prescribed for the relief of menopausal symptoms and
osteoporosis, provides the opportunity to optimize clinical outcomes
for coronary heart disease among the large and expanding population of
postmenopausal women.?
http://www.medscape.com/viewarticle/484038?src=search
?The contribution of C-reactive protein (CRP) to CHD risk is an
important consideration and it may be of particular prognostic
importance in older women. Among 27,939 women (mean age 54.7 years)
from the Women's Health Study (WHS), CRP was a stronger predictor of
cardiovascular events than low-density lipoprotein (LDL) cholesterol
and in the Women's Health Initiative (WHI) observational study, CRP
independently predicted cardiovascular events. CRP levels also added
prognostic information among women with all levels of severity of the
metabolic syndrome in the WHS.?
http://www.medscape.com/viewarticle/484038_2
Short-Term Efficacy and Safety of Extended-Release Fluvastatin in a
Large Cohort of Elderly Patients
?The efficacy and safety of lipid-lowering agents in elderly
individuals have not been extensively assessed. This population
generally takes more drugs concurrently than middle-aged patients, and
are therefore at higher risk of drug-drug interactions.?
http://www.medscape.com/viewarticle/460843
Additional Reading
http://www.health.state.ny.us/nysdoh/heart/aboutchd.htm
Air pollution may be a risk factor
http://bric.postech.ac.kr/science/97now/02_3now/020311c.html
The chart on page 9 of this study shows heart disease mortality ratios
of women smokers vs. non-smokers
http://profiles.nlm.nih.gov/NN/B/B/T/L/_/nnbbtl.pdf
Statins good for bone health
http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=273&topcategory=Women
Study shows statins may reduce breast cancer incidence
http://www.reducecholesterol.org/ms/news/518552/main.html
http://www.healthandage.com/Home/gc=29!gid1=4968
Statins reduce inflammation
?Although the important role of cholesterol in atherosclerosis is
widely accepted by scientists, research also shows that
atherosclerosis is a complex process that involves more than just
cholesterol. For example, scientists have discovered that inflammation
in the walls of the arteries may be an important factor in
atherosclerosis. New research shows that statins reduce inflammation,
which could be another mechanism by which statins beneficially affect
atherosclerosis. This reduction of inflammation does not depend on
statins' ability to reduce cholesterol. Further, these
anti-inflammatory effects can be seen as early as two weeks after
starting statins.?
http://www.medicinenet.com/statins/article.htm
I hope you feel this additional information can help you discuss
statins with your doctor, to arrive at the best course of treatment
for your particular case. Remember, genetics often plays a guilty role
in women who eat a low fat diet, exercise, do not smoke, etc., yet
still have a high total cholesterol. Statins may be for you, but your
doctor can give you the best overall plan for lowering your risk of
heart disease. I?m sorry I was unable to find more precise numbers for
you, but I seriously doubt is such hard data exists. If it does, I was
unable to locate it.
Sincerely,
crabcakes
