Women suffer more adverse reactions from cardiovascular drugs and should receive lower dosages than men, according to a position paper from the European Society of Cardiology published in the European Heart Journal – Cardiovascular Pharmacotherapy.
Heart diseases kill a greater proportion of women than men. Medications to treat these conditions can help prolong life. Yet, recommended doses of cardiovascular drugs are based on clinical trials in middle-aged men, said lead author Dr. Juan Tamargo, director of the Cardiovascular Pharmacology Research Group, Universidad Complutense in Madrid, Spain. “Women have more adverse reactions from current dosages and may stop taking preventative medication, leaving them unprotected despite their higher risk.”
Compared to men, women have a 1.5- to 1.7-fold greater risk of experiencing adverse events from their cardiovascular medication, and their symptoms tend to be more severe than men, often requiring hospitalization. These adverse events include the life-threatening drug-induced torsades de pointes and severe bleeding. Statin-induced myopathy, a serious muscle tissue disease, is also more common in women with low birth weight.
Tamargo’s paper outlines the differences between men and women with respect to cardiovascular treatments. For example, he says that women receive preventative treatment less often and are treated less aggressively than men. They also absorb, distribute, metabolize and excrete drugs differently than men and as a result are more likely to experience side effects – and suffer them worse – than their male counterparts.
“Male physicians less often prescribe recommended medications for female patients. Some doctors think cardiovascular disease is not a real issue for women because they are protected by sex hormones, forgetting that this disappears with age and women live longer than men,” he said.
Tamargo’s paper recommends that sex-specific guidelines for cardiovascular dugs be developed and implemented, more women be sought for clinical trials of cardiovascular drugs, and that doctors be educated about the sex differences in the pharmacokinetics and pharmacodynamics of these medications.