Women should take lower dosages of cardiovascular drugs to help prevent adverse reactions, a new Spanish study has concluded.
Dr Juan Tamargo, director of the Cardiovascular Pharmacology Research Group, Universidad Complutense, Madrid, said women have a 1.5 to 1.7-fold greater incidence of adverse reactions.
They have a higher risk of drug-induced torsades de pointes and severe bleeding – while women with a low body weight are more likely to suffer statin-induced myopathy, the researchers say.
Part of the reason is because cardiovascular dug recommendations are based on clinical trials involving middle-aged men, he said.
“Women have more adverse reactions because for many drugs the same dose is recommended for everyone irrespective of body weight,” said Dr Tamargo. “This can lead to higher plasma levels and overdoses in women.”
A position paper from the European Society of Cardiology, which is published in the latest edition of Cardiovascular Pharmacotherapy states that women are at greater risk of cardiovascular disease than men because they live longer and that adverse drug reactions are more severe and more common in women than men.
It also points out that women absorb, distribute, metabolise, and excrete drugs differently from men and are less likely to receive preventive treatments and are treated less aggressively than men.
To counter the problems, Dr Tamargo recommends the development and implantation of sex-specific guidelines for cardiovascular drugs, which should also be included on drug labels. He also called for women to be enrolled in clinical trials of cardiovascular drugs and the education of doctors about the differences between men and women in the pharmacokinetics and pharmacodynamics of cardiovascular drugs.
“Cardiovascular diseases kill a greater proportion of women than men in Europe and they kill twice as many women as all cancers combined,” said Dr Tamargo.
“The most effective way to minimise adverse drug reactions in women is to develop and implement sex-specific guidelines for cardiovascular drugs.”
Tamargo J, et al. Gender differences in the effects of cardiovascular drugs. Cardiovascular Pharmacotherapy June 2017; doi:10.1093/ehjcvp/pvw042
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