Gender features of the effectiveness of lipid-lowering therapy in patients with metabolic syndrome

Abstract

Objective. Rate lipid-correction effect, the effect on C-reactive protein (CRP), intima-media thickness (IMT) and the remodeling of the left ventricle (LV) of lipid-lowering therapy in men and women with metabolic syndrome (MS).
Materials. 1172 patients with MS (81 male and 91 female), median age 59 (52-67) years. All patients were assigned to simvastatin 20 mg daily, sufficient to reach the level of low density lipoprotein cholesterol (LDL-C) in 29 patients . The remaining patients were randomized into two groups: the first group, the dose of simvastatin was increased to 40 mg daily, patients second group was assigned the combination of simvastatin 20 mg and 10 mg ezetimibe.
Methods. Biochemical tests – lipid profile, CRP was assessed at baseline and at 1, 2 and 6 months. Echocardiography and Doppler ultrasound IMT of the carotid arteries was performed before and after 6 months of treatment
Results. Monotherapy with simvastatin 40 mg daily provided the achievement of the target level of LDL cholesterol in 81.2% of men and 55.9% of women (p<0.05), and combination therapy – in 86.8% of women and 64.1% of men (p<0.05). After 6 months of simvastatin monotherapy or combination therapy in men changes in CRP, IMT were comparable; women combined therapy was superior to monotherapy on the effect on the studied parameters. Simvastatin monotherapy and
combination therapy were accompanied by improvements in left ventricular remodeling in both sexes (p<0.05), but a more pronounced positive changes were observed in women on combined therapy. In men, the effectiveness of simvastatin monotherapy and combination therapy on left ventricular remodeling parameters were comparable.
Conclusion. Simvastatin monotherapy and combination therapy with simvastatin and ezetimibe , regardless of gender lipid-correction provide reliable, antiinflammatory, anti-remodeling effects in patients with MS. In men, the tactics of both lipid-lowering therapy are equally effective in women is more significant dynamics of indicators was observed with combination therapy.