Drug That Lowers Cholesterol May Also Prevent Strokes
Aug. 2, 2000 -- A popular drug used to lower high cholesterol has an added benefit of reducing the risk of stroke in people who have had a heart attack or suffer from the crushing chest pain.
In a large study appearing in the Aug. 3 issue of The New England Journal of Medicine, researchers say people who took the cholesterol-lowering drug Pravachol had almost 23% fewer ischemic strokes than people who did not. Ischemic strokes -- caused by blood clots -- are the most common type of strokes, accounting for about 90% of all strokes. This is also the type of stroke suffered by former President Gerald Ford this week.
"There's very good data already that cholesterol-lowering drugs [should be given to] ? people who have heart disease," says Howard Kirschner, MD. "This study is similar to three others that have shown a benefit of the cholesterol-lowering agents on stroke." Kirshner is vice chairman of the department of neurology at Vanderbilt University School of Medicine in Nashville, Tenn., and was not involved with the study.
Pravachol belongs to a class of drugs known as statins, and researchers aren't sure how they prevent stroke or even if all drugs in this class have the same benefit.
Kevin Maki, PhD, tells WebMD statins give doctors new options for treating people at risk for stroke who would otherwise only have the option of drugs that prevent blood clots from forming, such as aspirin and warfarin.
"What this study shows is that the statins have an effect above and beyond the aspirin, so the combination would seem to be ideal for somebody who has had a previous [heart-related] event," says Maki, who is vice president of the Chicago Center for Clinical Research.
In the study, Harvey D. White, DSc, of the Green Lane Hospital in Auckland, New Zealand, and colleagues randomly assigned more than 9,000 people who had had a heart attack or chronic chest pain to take Pravachol or a placebo pill daily for six years. The average age of patients in both groups was 63 years. Nearly half of patients in each group also had high cholesterol.
Over the six years, strokes occurred in 4.5% of the placebo group compared with 3.7% of the Pravachol group. Compared with those taking the dummy pill, those on Pravachol also had over 20% reduced risk of dying from heart disease or any other cause.
During the first five years of therapy, total cholesterol levels in the those patients taking Pravachol also decreased by 18%, "bad" LDL cholesterol decreased by 27%, triglycerides -- another fat which circulates in the blood -- decreased by 6%, and "good" HDL cholesterol increased by 4%.
Most of the research on preventing strokes has been done in patients with heart disease who have high cholesterol, but researchers say given the good results, it may now be OK to give statins to people with a heart disease history who don't have what would be considered high cholesterol.
Kirschner adds there is a risk for bleeding in the brain in people with very low cholesterol who take statins, but he says people with normal cholesterol levels can probably safely take the drugs if their risk of stroke is high enough to warrant it.