April 23, 1997

Treatment of Hypercholesterolemia in WomenEquality, Effectiveness, and Extrapolation of Evidence

Author Affiliations

From the Mary Imogene Bassett Research Institute, Cooperstown, NY (Drs Pearson and Myerson), and the Departments of Public Health and Medicine, Columbia University, New York, NY (Dr Pearson). Dr Pearson is now with the Department of Community and Preventive medicine, University of Rochester School of Medicine, Rochester, NY.

JAMA. 1997;277(16):1320-1321. doi:10.1001/jama.1997.03540400070035

The well-established fact that male sex is a risk factor for coronary heart disease (CHD) has been interpreted by some clinicians that CHD risk is lower for all women, that risk factors for CHD morbidity and mortality are somehow less predictive in women than in men, and that interventions to reduce that risk of CHD are inherently less effective in women. In this issue of The JOurnal, Schrott et al1 describe the extent to which lipid abnormalities are treated in women, identifying those factors that are associated with achieving (or not achieving) goals in low-density lipoprotein (LDL) cholesterol levels as set forth by the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) guidelines. In 2763 postmenopausal women with documented CHD recruited into a clinical trial of estrogen replacement therapy, 91% did not meet the NCEP ATP-II goals of an LDL cholesterol level of 2.6 mmol/L (100 mg/dL) or