Management of cholesterol to reduce the burden of stroke in Asia: consensus statement.
Stroke is a major cause of morbidity and mortality in Asia, and its pattern is changing. The incidence of haemorrhagic stroke is declining while the incidence of ischaemic stroke caused by large artery atherothromboembolism is increasing secondary to an increase in the prevalence of hypercholesterolaemia. The Working Group on Stroke and Lipids Management in Asia Consensus Panel assembled leading experts from the region to reach a consensus on how to address this challenge. The group discussed the observational epidemiology of the relationship between cholesterol and risk of stroke, the clinical trial evidence base for cholesterol-lowering for stroke prevention, and issues specific to stroke and lipid management for Asian doctors and patients. Stroke guidelines from many of the Asian countries have recently recommended consideration of statins for recurrent stroke prevention in patients with previous ischaemic stroke or transient ischaemic attack. However, because these recommendations have yet to be implemented widely, there is a need to educate Asian physicians and patients about the importance of adequate control of hypercholesterolaemia. Further trials of statins in Asian patients are also needed, particularly in those with intracranial stenosis.
Hankey
Graeme J
GJ
Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Australia. gjhankey@cyllene.uwa.edu.au
Wong
Ka S L
KS
Chankrachang
Siwaporn
S
Chen
Christopher
C
Crimmins
Denis
D
Frayne
Judith
J
Kim
Jong S
JS
Li
Yansheng
Y
Liou
Chia-Wei
CW
Merican
Julia S
JS
Misbach
Jusuf
J
Navarro
Jose
J
Shinohara
Yukito
Y
Wang
Yongjun
Y
Yoon
Byung-Woo
BW
D001208:Asia / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D032921:Consensus; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000150:complications* / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics / Q000517:prevention & control*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol