Statins in stroke prevention: what an internist should know

European Journal of Internal Medicine
Luis Castilla GuerraMaría Dolores Jiménez Hernández

Abstract

Historically, the etiological link between hypercholesterolemia and stroke has been less clear than for coronary heart disease. The lack of association between cholesterol levels and stroke in most epidemiological and observational studies has brought about this controversy. Many recent, long-term clinical studies have confirmed that statin therapy results in a reduced risk of strokes, even in so-called "normocholesterolemic" patients. The magnitude of the effect is great. A large-scale analysis of more than 90,000 individuals showed that every 10% reduction in the concentration of LDL-cholesterol reduces the risk of stroke by 15.6%. The positive effect of statins on stroke depends mainly on LDL cholesterol reduction, but other non-lipid mechanisms, so-called "pleiotropic" effects, have been shown to play a role. This review seeks to summarize the role of statins in stroke prevention. Despite the fact that our understanding of the benefits of statins in stroke prevention is still evolving, we find marked room for improvement in stroke risk factor management. Internists must face this challenge and integrate this new knowledge into their daily clinical practice.

References

Nov 1, 1989·Stroke; a Journal of Cerebral Circulation·K YanoC J MacLean
Jul 22, 1998·Proceedings of the National Academy of Sciences of the United States of America·M EndresJ K Liao
Nov 30, 2002·Lancet·James ShepherdUNKNOWN PROSPER study group. PROspective Study of Pravastatin in the Elderly at Risk
Dec 25, 2003·Cerebrovascular Diseases·Pierre AmarencoPierre-Jean Touboul
Jun 17, 2004·Circulation·Pierre Amarenco, Andrew M Tonkin
Sep 11, 2004·Journal of the American College of Cardiology·Scott M GrundyUNKNOWN Coordinating Committee of the National Cholesterol Education Program
Oct 30, 2004·Stroke; a Journal of Cerebral Circulation·Pierre AmarencoPierre-Jean Touboul
Jan 12, 2005·Archives of Neurology·Bruce OvbiageleJeffrey L Saver
Sep 24, 2005·Stroke; a Journal of Cerebral Circulation·James KennedyThomas E Feasby
Dec 6, 2005·Cerebrovascular Diseases·José Vivancos-Mora, Antonio C Gil-Núñez
Dec 21, 2005·Thrombosis and Haemostasis·Laura CasaniLina Badimon
Mar 25, 2006·Stroke; a Journal of Cerebral Circulation·Luis Castilla-GuerraMaría Dolores Jimérnez
Apr 26, 2006·Neurology·B OvbiageleUNKNOWN VISP Study Investigators
Aug 11, 2006·The New England Journal of Medicine·David M Kent
Sep 22, 2006·Lancet Neurology·Graeme J Hankey

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Citations

Sep 24, 2013·Clinical Reviews in Allergy & Immunology·Jinting XiaoJunwei Hao
May 24, 2015·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Fatemeh GhasemiKambiz Hassanzadeh
Mar 6, 2012·European Journal of Internal Medicine·Mojca LunderMišo Sabovič
Sep 29, 2009·European Journal of Internal Medicine·Luis Castilla-GuerraJesus Alvarez-Suero
May 12, 2009·Progress in Neurobiology·Peter J van der MostUlrich L M Eisel
Nov 18, 2008·European Journal of Internal Medicine·Luca MascitelliMark R Goldstein
Mar 20, 2015·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Tan WangBeisha Tang
Jun 5, 2017·Metabolic Brain Disease·Seyed Soheil Saeedi SaraviAhmad Reza Dehpour
Jul 20, 2021·Journal of Oral Biosciences·Keita KagawaTakuro Sanuki

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