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Stroke prevention, blood cholesterol and statins.

Abstract

Statins have a good overall safety profile to date, with no increase in haemorrhagic stroke or cancer. They have favourable effects in the primary prevention of cardiovascular disease in high-risk young as well as elderly populations. Statins reduce the incidence of stroke in high-risk populations (mainly CHD patients, diabetics and hypertensives) even with a normal baseline blood cholesterol level, which argues for a global cardiovascular risk-based treatment strategy. As for CHD, stroke reduction was mainly observed in studies with large between-group LDL cholesterol difference. In patients with prior strokes, statins reduce the incidence of coronary events, but it is not yet proven that they actually reduce the incidence of recurrent strokes in secondary prevention. From a practical point of view, since there was a favourable treatment effect overall in stroke and TIA patients in HPS, it seems reasonable to treat stroke patients with a statin and total cholesterol >135 mg/dL (3.5 mmol/dL). On-going research is aiming to refine patient selection. As anticipated by current US recommendations, patients who are likely to benefit most are those with carotid atherosclerosis, diabetes mellitus, previous coronary heart disease, hypertension, hypercholesterolaemia, or cigarette smoking and LDL cholesterol > 100 mg/dL.

Authors+Show Affiliations

,

Department of Neurology and Stroke Centre, Bichat University Hospital and Medical School, Denis Diderot University-Paris VII, 46 rue Henri Huchard, 75018 Paris, France. amarenco@ccr.jussieu.fr

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Source

Acta neurologica Taiwanica 14:3 2005 Sep pg 96-112

MeSH

Atorvastatin
Cholesterol
Clinical Trials as Topic
Heptanoic Acids
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pravastatin
Pyrroles
Risk Factors
Stroke

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16252611

Citation

Amarenco, Pierre, et al. "Stroke Prevention, Blood Cholesterol and Statins." Acta Neurologica Taiwanica, vol. 14, no. 3, 2005, pp. 96-112.
Amarenco P, Lavallée PC, Labreuche J, et al. Stroke prevention, blood cholesterol and statins. Acta Neurol Taiwan. 2005;14(3):96-112.
Amarenco, P., Lavallée, P. C., Labreuche, J., & Touboul, P. J. (2005). Stroke prevention, blood cholesterol and statins. Acta Neurologica Taiwanica, 14(3), pp. 96-112.
Amarenco P, et al. Stroke Prevention, Blood Cholesterol and Statins. Acta Neurol Taiwan. 2005;14(3):96-112. PubMed PMID: 16252611.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stroke prevention, blood cholesterol and statins. AU - Amarenco,Pierre, AU - Lavallée,Philippa C, AU - Labreuche,Julien, AU - Touboul,Pierre-Jean, PY - 2005/10/29/pubmed PY - 2005/11/11/medline PY - 2005/10/29/entrez SP - 96 EP - 112 JF - Acta neurologica Taiwanica JO - Acta Neurol Taiwan VL - 14 IS - 3 N2 - Statins have a good overall safety profile to date, with no increase in haemorrhagic stroke or cancer. They have favourable effects in the primary prevention of cardiovascular disease in high-risk young as well as elderly populations. Statins reduce the incidence of stroke in high-risk populations (mainly CHD patients, diabetics and hypertensives) even with a normal baseline blood cholesterol level, which argues for a global cardiovascular risk-based treatment strategy. As for CHD, stroke reduction was mainly observed in studies with large between-group LDL cholesterol difference. In patients with prior strokes, statins reduce the incidence of coronary events, but it is not yet proven that they actually reduce the incidence of recurrent strokes in secondary prevention. From a practical point of view, since there was a favourable treatment effect overall in stroke and TIA patients in HPS, it seems reasonable to treat stroke patients with a statin and total cholesterol >135 mg/dL (3.5 mmol/dL). On-going research is aiming to refine patient selection. As anticipated by current US recommendations, patients who are likely to benefit most are those with carotid atherosclerosis, diabetes mellitus, previous coronary heart disease, hypertension, hypercholesterolaemia, or cigarette smoking and LDL cholesterol > 100 mg/dL. SN - 1028-768X UR - https://www.unboundmedicine.com/medline/citation/16252611/Stroke_prevention_blood_cholesterol_and_statins_ L2 - https://medlineplus.gov/cholesterolmedicines.html DB - PRIME DP - Unbound Medicine ER -