What could be the matter with screening for heart disease?

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Heart disease is still the number one killer of women in Canada and appropriate screening for heart disease is clearly important. Some of the symptoms of heart attacks differ for women and men and screening for women should account for these differences. But screening should not overdiagnose and lead to unnecessary treatment. The trend to prescribing statins – cholesterol lowering drugs that are the most widely prescribed drugs in the world – in healthy women to prevent heart disease is a hotly debated issue.  Some recent studies have shown both an association between statins and the risk of Type 2 diabetes in older women, and that statins may not be as helpful in preventing deaths from heart attacks in healthy women as in men.

Statins May Raise Diabetes Risk in Older Women
WebMD, January 9, 2012
Reports on a study finding that cholesterol-lowering statin drugs may be associated with an increased risk of diabetes in middle-aged and older women. 

The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs
By Barbara H. Roberts, Pocket Books, New York NY, 2012
A book examining the risks of taking statins, including a chapter on women and statins. Roberts has also written, How to Keep from Breaking Your Heart: What Every Woman Needs to Know about Cardiovascular Disease.

Evidence for Caution: Women and Statin Use
By Harriet Rosenberg and Danielle Allard, Women and Health Protection, 2007
Reviews the evidence – and the lack of evidence – for benefit and harm from statins in women. Discusses the fact that most of the clinical trials to assess their benefits and safety have focused on men. Argues that far more research is needed in how statins affect women, and makes a number of recommendations to Health Canada for monitoring its effects and use in women.

Women and Heart Health
Canadian Women’s Health Network, 2006
An FAQ discussing how heart disease affects women differently than men and how to recognize the signs and symptoms.

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Women, gender and medical screening