title: Statins in hemorrhagic stroke.
abstract: Statin therapy has a major impact on the treatment of coronary artery disease and also has an impact on the treatment of ischemic stroke. Both clinical and experimental studies support the concept of statin actions beyond those of lipid lowering per se (pleiotrophic effects). In this article, we briefly review the clinical, experimental and biological data on the actions of statins and then review the literature regarding the impact of statin use on the two major forms of hemorrhagic stroke: aneurysmal subarachnoid hemorrhage and intracranial hemorrhage (ICH). We make recommendations regarding acute statin therapy, statin withdrawal and chronic statin therapy, including a possibly negative impact - the increased incidence of ICH associated with the use of higher doses of statin in patients with a prior history of stroke. Epidemiological data on the association between low total cholesterol or low levels of low-density cholesterol, hypertension and the incidence of ICH appear relevant and are also discussed. We speculate on the relationship between data derived from randomized controlled trials employing statin and ICH epidemiology.
authors.affiliation: Department of Neurology, Loyola University Chicago, Stritch School of Medicine, IL, USA. mflaster@lumc.edu
authors.forename: Murray
authors.initials: M
authors.lastname: Flaster
authors.forename: Sarkis
authors.initials: S
authors.lastname: Morales-Vidal
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Schneck
authors.forename: José
authors.initials: J
authors.lastname: Biller
mesh_terms: D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D020300:Intracranial Hemorrhages / Q000150:complications / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors