Atorvastatin calcium: SPECIAL PATIENT POPULATIONS Women(1)
Postmenopausal women generally experience an increase in LDL-C level and a decrease in HDL-C level . Because of this change in lipid profile, which is associated with an increased risk of CAD, many postmenopausal women are treated with lipid-regulating medications . Estrogen is prescribed for its lipid-regulating effects as well as for its other beneficial effects in this population. However, estrogen typically raises triglyceride levels , which is an independent cardiovascular risk factor in this patient population . In a one-year study of postmenopausal women with primary hyperlipidemia, atorvastatin monotherapy (10 mg/ day) was compared with estradiol monotherapy (1 mg/day) and with combination therapy of atorvastatin 10 mg/day plus estradiol 1 mg/day.
Atorvastatin monotherapy was significantly more effective in lowering elevated levels of LDL-C, total cholesterol, apo B and triglycerides than estradiol monotherapy (Table 5). Reductions in LDL-C, total cholesterol and apo B were similar for combination therapy (atorvastatin plus estradiol) and atorvastatin monotherapy. However, HDL-C levels were significantly higher for combination therapy than for atorvastatin monotherapy. Triglyceride levels were lower with atorvastatin monotherapy compared with combination therapy.
TABLE 5 Efficacy of lipid lowering therapies in postmenopausal women (mean percentage change from baseline)
|Lipidparameter||Atorvastatin 10 mg/day (n=20)||Estradiol 1 mg/day (n=17)||Atorvastatin 10 mg/day plus estradiol 1 mg/day (n=23)|
*P<0.05 versus atorvastatin monotherapy. ApoB Apolipoprotein B; HDL-C High density lipoprotein cholesterol; LDL-C Low density lipoprotein cholesterol; VLDL-C Very low density lipoprotein cholesterol. Based on data from reference 75