Statin Cholesterol Drugs Lower Stroke Risk

March 4, 2004 -- Cholesterol-lowering statin drugs can prevent strokes among high-risk people, a new study shows.

"Statin therapy should now be considered routinely for all patients at high risk of stroke, irrespective of their initial cholesterol concentrations or the presence of heart disease," writes lead researcher Rory Collins, PhD, an epidemiologist with Radcliffe Infirmary in Oxford, England.

"It is clear that the beneficial effect on stroke emerges rapidly, with a highly significant reduction within two years of starting [Zocor]," Collins says. "Even more prolonged statin therapy would eventually produce even larger reductions in stroke risk."

His paper appears in The Lancet this week.

Cholesterol and Stroke

Prior studies have not shown a strong link between high cholesterol and stroke, writes Collins.

Before statins were available, cholesterol-lowering drugs and diets had only modest effect on cholesterol and heart disease but did not seem to alter stroke risk, he explains. Statins have shown promise in stroke prevention, but this is the first large study of this effect.

Lower Cholesterol, Prevent Stroke

Collins' study involved close to 3,300 people with a history of strokes. In addition, more than 17,000 other people were included who were at high risk of stroke due to having other problems caused by blood vessel blockages, such as heart disease, or diabetes.

They were randomly assigned to take either the statin drug Zocor or a placebo daily for about five years. Researchers followed up on their progress during the next five to eight years.

The Zocor-treated group had:

• A 25% reduction in nonfatal first strokes and heart attacks

• A 28% reduction in strokes caused by clogged arteries

• A 23% decrease in heart attack, among those with previous history of strokes

There also was no increase in strokes due to bleeding in the brain, helping put to rest one concern that researchers have raised about statin drugs, writes Collins.

Other findings:

• The Zocor group had fewer mini strokes.

• The reduction in strokes showed up by the end of the second year.

• Among patients who had a previous stroke, Zocor did not prevent a second stroke but did appear to reduce the risk of other problems due to clogged arteries, such as heart attacks.

This study shows that cholesterol-lowering statin therapy rapidly produces a definite and substantial reduction in stroke due to clogged arteries irrespective of the patient's age, sex, or cholesterol level, writes Collins.

It also demonstrates that statin treatment reduces the risk of other problems due to clogged arteries, such as heart disease, among people who have had a previous stroke, he writes.

The results should change treatment of patients at high risk for stroke, writes Collins.