Effects of age, gender and statin dose on lipid levels: Results from the VOYAGER meta-analysis database

Atherosclerosis. 2017 Oct:265:54-59. doi: 10.1016/j.atherosclerosis.2017.08.014. Epub 2017 Aug 19.

Abstract

Background and aims: The effectiveness of statins in the treatment of dyslipidaemia and reduction of cardiovascular risk is well established. However, the association of statin-mediated lipid effects with age and gender is unclear. This study aimed to determine whether age and gender are associated with statin-mediated changes in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and non-HDL-C.

Methods: Individual patient data (n = 32,258) were obtained from VOYAGER. Least-squares mean percentage change from baseline in LDL-C, non-HDL-C and HDL-C with atorvastatin 10-80 mg, rosuvastatin 5-40 mg or simvastatin 10-80 mg was estimated in women aged <70 years, women aged ≥70 years, men aged <70 years and men aged ≥70 years.

Results: All statins and doses gave significant dose-dependent reductions in LDL-C and non-HDL-C, and increases in HDL-C, in all four patient groups. A 2.1% greater reduction in LDL-C was observed in women, compared with men (p < 0.0001). Patients aged ≥70 years experienced a 2.7% greater reduction in LDL-C compared with younger patients (p < 0.0001). Similar results were also observed for statin-mediated changes in non-HDL-C. Men experienced a significantly greater increase in HDL-C than women, and patients aged ≥70 years achieved a significantly greater increase than younger patients (both p = 0.001).

Conclusions: While statins improve the lipid profile in all gender and age groups analysed, the improvements are greater in women than in men and in those aged ≥70 years compared with those aged <70 years.

Keywords: Age; Dyslipidaemia; Elderly; Gender; Statins; Women.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Age Factors
  • Aged
  • Atorvastatin / administration & dosage*
  • Biomarkers / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Databases, Factual
  • Dose-Response Relationship, Drug
  • Dyslipidemias / blood
  • Dyslipidemias / diagnosis
  • Dyslipidemias / drug therapy*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Least-Squares Analysis
  • Lipids / blood*
  • Male
  • Middle Aged
  • Rosuvastatin Calcium / administration & dosage*
  • Sex Factors
  • Simvastatin / administration & dosage*
  • Treatment Outcome

Substances

  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids
  • Rosuvastatin Calcium
  • Atorvastatin
  • Simvastatin