Statins for stroke prevention.
Unlike coronary heart disease, epidemiologic studies find a weak and inconsistent relationship between cholesterol levels and overall stroke risk. There does, however, appear to be a positive relationship between total and low-density lipoprotein cholesterol levels and the risk of ischemic stroke, with an inverse relationship between cholesterol levels and hemorrhagic stroke. Treatment with statins is associated with the reduction in the risk of a first stroke in various populations of patients at increased risk of cardiovascular events. Treatment of patients with prior cerebrovascular disease is associated with a reduction in major cardiovascular events and, in a single study, with a reduction in fatal and nonfatal stroke in patients with prior stroke or transient ischemic attack and no known coronary heart disease. Whether the benefit of statins in reducing the risk of stroke is due to their potent lipid-lowering effects, pleiotropic effects, or a combination of the two cannot be determined based on data available from clinical trials.
Goldstein
Larry B
LB
Duke Center for Cerebrovascular Disease, Stroke Policy Program, Center for Clinical Health Policy Research, Box 3651, Duke University Medical Center, Durham, NC 27710, USA. golds004@mc.duke.edu
D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D002986:Clinical Trials as Topic; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000209:etiology / Q000517:prevention & control*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors