Neurology Now:
doi: 10.1097/01.NNN.0000316772.96157.89
Department: the Waiting Room: This Way in

Statins and Stroke

Hurley, Dan

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People who started taking a cholesterol-lowering drug after a stroke lowered their risk of having a second stroke by one-fifth on average, according to a large study published in the New England Journal of Medicine in 2006.

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For the study of 4,731 people, half were given the drug atorvastatin (Lipitor), one of many cholesterol-lowering drugs known as “statins,” and half were given an inactive placebo pill. Those who got the drug saw the level of their “bad” cholesterol, LDL, drop by 53 percent on average in just one month.

“For each 10 percent drop in LDL, the risk of stroke dropped 4 percent, and the risk of heart attack dropped 7 percent,” says the leader of the study, Pierre Amarenco, M.D., Ph.D., of Denis Diderot University in Paris, France.

All the participants had suffered either a stroke or so-called “mini” stroke, but none of them had any sign of heart disease when the study began. Those given atorvastatin took it at the highest allowed dose, 80 mg. All the participants were followed up for four and a half years.

“The take-home message should be that statin drugs reduce the risk of stroke and heart disease in patients with or without underlying heart disease,” says Majaz Moonis, M.D., director of the Stroke Prevention Clinic at the University of Massachusetts Memorial Medical Center in Worcester.

The drug reduced the risk of so-called ischemic stroke (caused by a blockage in a blood vessel within the brain) by a whopping 21 percent, according to a secondary analysis of the study published online in the American Academy of Neurology's journal Neurology in December of 2007. But it also slightly increased the risk of hemorrhagic stroke (caused by bleeding in a blood vessel of the brain), by just under 1 percent. So overall, doctors emphasized that the benefit far outweighed the risk.

The study, called Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL), was sponsored by Pfizer, Inc., the maker of Lipitor.

Dan Hurley

©2008 American Academy of Neurology

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