22
Women's Health
Special Populations
Chart 6. Women's Health
Recommendations
Strength Quality
In general, women should be treated according to the NLA
Recommendations for Patient-Centered Management
of Dyslipidemia – Part 1 with the following special
considerations.
A High
First-line cholesterol-lowering drug therapy, unless
contraindicated, is moderate- to high-intensity statin. e
statin dosage may be increased or the patient switched to a
more efficacious agent if goal levels of atherogenic cholesterol
are not achieved. Statin therapy should be a consideration
for patients at very high risk (i.e., ASCVD or diabetes
mellitus with ≥2 major ASCVD risk factors), even if the
pre-treatment levels of atherogenic cholesterol are below the
treatment goals.
A High
Non-statin drug therapy with cholesterol absorption
inhibitor, bile acid sequestrant, fibric acid, nicotinic acid,
or long-chain omega-3 fatty acid concentrates (the latter
currently indicated only for very high TG) may be considered
for women with contraindications for, or intolerance to,
statin therapy, or in combination with statin therapy for
patients who need additional lowering of atherogenic
cholesterol to achieve treatment goals.
A High
Women taking statins may be at increased risk for certain
adverse events, particularly myalgia. Variations between men
and women observed in clinical studies of statin-related
myalgia incidence may have been related to differences in age,
comorbidities, body composition, and polypharmacy.
B Low
Chart 7. Pregnancy to Menopause
Recommendations
Strength Quality
Women should be screened for dyslipidemia before
pregnancy or as part of the routine obstetrical laboratory
examination.
E Low
For women taking lipid-lowering medications prior to
pregnancy, all, except bile acid sequestrants, should be
stopped when the woman becomes pregnant, or is trying to
become pregnant.
B Moderate
Women should be educated on the importance of pregnancy
avoidance when lipid-altering therapies other than bile acid
sequestrants are used.
A Moderate
