A team of researchers has recommended to develop sex-specific dosages to protect greater proportion of women dying from heart diseases in order to reduce the adverse reactions of cardiovascular drugs in women. According to the study, Aspirin has a higher protective effect against stroke and heart attack than in men, where aspirin is more active in male platelets and is more resistant in women. Cardiovascular drug recommendations are based on clinical trials in middle-aged men. The study highlights the differences between women and men with respect to cardiovascular medications and gives recommendations on how to improve treatment in women.
According to the researchers, adverse drug reactions are more severe and more common in women than in men. The findings indicated that women have a 1.5 to 1.7-fold greater incidence of adverse reactions to cardiovascular drugs and they tend to be more severe in men, often leading to hospital admission.
Lead author Juan Tamargo from Universidad Complutense, Madrid, Spain said that cardiovascular diseases kill a greater proportion of women than men in Europe and they kill twice as many women as all cancers combined. Women have more adverse reactions from current dosages and may stop taking preventive medication, leaving them unprotected despite their higher risk. They have more adverse reactions because for many drugs the same dose is recommended for everyone irrespective of body weight and this can lead to higher plasma levels and overdoses in women.
Tamargo noted that 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. Sex-related recommendations for drug dosages are not included on labels, even for drugs with a greater than 40 percent difference in pharmacokinetics between men and women, as there are sex-related differences in the pharmacokinetics (the way a drug is absorbed, distributed, biotransformed and excreted) of some widely used cardiovascular drugs.
The researchers suggested that to include sex-specific dosages on cardiovascular drug labels and doctors should be educated about sex differences in the pharmacokinetics and pharmacodynamics of cardiovascular drugs.
The most effective way to minimise adverse drug reactions in women is to develop and implement sex-specific guidelines for cardiovascular drugs, the authors concluded.
The study is published in European Heart Journal - Cardiovascular Pharmacotherapy.