Elevated triglycerides and low high-density lipoprotein (HDL) levels are more important coronary risk factors in women, and elevated low-density lipoprotein (LDL) levels less important in women, than men. There is clear-cut evidence in clinical trials that the benefit of cholesterol lowering in women and men is virtually identical. Modifiers of lipids and lipoproteins in women include diabetes mellitus, bodyweight and its distribution, and menopausal status. Diabetes is a more powerful predictor of risk in women than men. This may relate to the importance of elevated triglycerides as a risk factor in women, and to the effects of lipoprotein glycosylation, which lead to increased susceptibility to arterial deposition of LDL and decreased reverse cholesterol transport with HDL. Therapy for lipoprotein disorders in women and men is identical. For the overwhelming majority of patients, treatment with statin therapy is both highly efficacious and well tolerated.
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