Lipid-Lowering Therapy in Women of Childbearing Age: a Review and Stepwise Clinical Approach.

Journal Article (Journal Article;Review)

PURPOSE OF REVIEW: Women are less often recognized to have cardiovascular disease (CVD) risk and are underrepresented in randomized trials of lipid-lowering therapy. Here, we summarize non-pharmacologic and pharmacologic strategies for lipid-lowering in women of childbearing age, lipid changes during pregnancy and lactation, discuss sex-specific outcomes in currently available literature, and discuss future areas of research. RECENT FINDINGS: While lifestyle interventions form the backbone of CVD prevention, some women of reproductive age have an indication for pharmacologic lipid-lowering. Sex-based evidence is limited but suggests that both statin and non-statin lipid-lowering agents are beneficial regardless of sex, especially at high cardiovascular risk. Pharmacologic lipid-lowering therapies, both during the pregnancy period and during lactation, have historically been and continue to be limited by safety concerns. This oftentimes limits lipid-lowering options in women of childbearing age. In this review, we summarize lipid-lowering strategies in women of childbearing age and the impact of therapies during pregnancy and lactation. The limited sex-specific data regarding efficacy, adverse events, and cardiovascular outcomes underscore the need for a greater representation of women in randomized controlled trials. More data on lipid-lowering teratogenicity are needed, and through increased clinician awareness and reporting to incidental exposure registries, more data can be harvested.

Full Text

Duke Authors

Cited Authors

  • Grant, JK; Snow, S; Kelsey, M; Rymer, J; Schaffer, AE; Patel, MR; McGarrah, RW; Pagidipati, NJ; Shah, NP

Published Date

  • October 2022

Published In

Volume / Issue

  • 24 / 10

Start / End Page

  • 1373 - 1385

PubMed ID

  • 35904667

Electronic International Standard Serial Number (EISSN)

  • 1534-3170

Digital Object Identifier (DOI)

  • 10.1007/s11886-022-01751-z


  • eng

Conference Location

  • United States