Are women discriminated against for lipid lowering therapy? Results from aprospective cohort of women with coronary artery disease

The objective of the study was to compare the lipid management of men and w omen with documented coronary artery disease in 587 patients (433 men and 1 54 women) undergoing coronary angiography between 1991 and 1995. A fasting total cholesterol (TC) was measured in all patients on the morning of angio graphy. A postal/telephone follow-up was carried out one year after angiogr aphy in a subpopulation of 278 patients (194 men and 84 women) who were not taking lipid-lowering therapy (LLT) or whose TC was >5.2 mmol/l at the tim e of angiography. At baseline, mean TC was 5.89 mmol/l (SE 0.06) in the men and 6.47 mmol/l (SE 0.09) in the women (p=<0.0001). Action or recommendati on to institute LLT was taken in 141 (32.7%) men and 62 (40.3%) women (p=0. 09). In the follow-up population, comparing men with women, 74 (38.3%) vs 3 9 (46.4%) were taking LLT (p=0.21); 56 (28.9%) vs 26 (31.0%) had not underg one repeat TC testing (p=0.73); when performed, repeat TC was 5.75 (0.09) m mol/l vs 5.64 (0.16) mmol/l (p=0.53); mean decrease in TC between baseline and follow-up was 0.86 (0.10) mmol/l vs 1.01 (0.21) mmol/l (p=0.51). There was no significant gender difference in lipid management either at the time of coronary angiography or subsequent follow-up, although the level of lip id-lowering drug use remained inadequate in both sexes.