- High cholesterol is a risk factor for many serious conditions such as heart disease.
- Many people manage their cholesterol with a class of prescription drugs called statins.
- A new study reviews whether statins may reduce the risk of certain kinds of stroke.
Someone in the United States has a stroke every 40 seconds.
The annual cost in dollars is in the tens of billions and that’s to say nothing of the cost in human lives. Any information we can glean on how to reduce the risk of stroke is generally welcome.
In that regard, a new Danish study published today in the medical journal Neurology examines how the use of statins might reduce the risk of certain types of stroke.
So what did the study find and what do experts have to say about it?
Statins and stroke
The study, which was funded by the Danish pharmaceutical company Novo Nordisk, was done retrospectively by analyzing Danish medical registries. That data spanned from 2009 to 2018.
In particular, the researchers were looking to find if the long-term use of statins could reduce the risk of a specific type of stroke called an intracerebral hemorrhage (ICH).
“Statins are medication to treat high cholesterol,” Dr. Jackie S. Fantes, FAAFP, the executive vice president and chief medical officer at East Boston Neighborhood Health Center, told Healthline.
“Statins are the gold standard and the best treatment. The other treatment that is very important, with or without statins, is lifestyle changes to include a healthy diet, weight loss, stop smoking, and exercise,” Fantes added.
Dr. Basit Rahim, director of stroke and neurocritical care at Providence Mission Hospital in Orange County, California, told Healthline that statins work, “by lowering cholesterol, specifically LDL, the ‘lousy’ or ‘bad’ cholesterol.”
How statins can help with stroke prevention
Statins could be an important tool for reducing stroke risk because they’re used frequently and serious side effects are uncommon. Every drug does come with some level of risk though.
“General [gastrointestinal] complaints like nausea or vomiting are common. Often people will complain of muscle pain. I caution use with those with liver problems,” said Rahim.
ICH strokes are the second-most common subtype of stroke.
“The majority of those with stroke [have] the ischemic kind, or lack of blood flow to a certain region of the brain (~80-85%). Hemorrhagic strokes are due to bleeding in the brain tissue and occur in 15 to 20 percent of strokes,” Dr. Shlee Song, the director of the Comprehensive Stroke Center and the Telestroke Program at Cedars-Sinai in Los Angeles, told Healthline.
In their study, researchers report that statin use did indeed reduce the risk of ICH stroke. The risk appeared to be further reduced for people who used statins for a longer period of time.
Experts agree on statins and strokes
The findings from this study were generally consistent with what experts expected.
“[It’s not surprising] to find that long-term statin use in the Danish population was associated with lower risk of ICH. Reducing cholesterol that contributes to atherosclerosis in the patient population likely reduces cerebrovascular and cardiovascular disease and therefore reduces both ischemic and hemorrhagic stroke risk,” said Song.
Dr. Sandra Narayanan, a vascular neurologist and neuro-interventional surgeon at Pacific Stroke & Neurovascular Center at Pacific Neuroscience Institute in California, told Healthline that “this effect was most noticeable in patients taking statins for greater than 5 years and is presumably due to reduced risk of cerebral atherosclerosis, which is a significant contributor to hemorrhagic stroke, particularly the non-lobar type.”
Dr. Alejandro Vargas, a stroke specialist at RUSH University Medical Center in Chicago, told Healthline that the study results weren’t surprising, but he also included some important caveats.
“The authors do note the limitation of not having important confounding information, such as blood pressure measurements, especially when it is a very common cause of intracerebral hemorrhage,” said Vargas.
“Another major caution with a study like this comes from being retrospective, so it can see an association, but can’t say that the statin was the cause of the reduced intracerebral hemorrhage risk,” he added.
Recognizing the signs of stroke and taking quick action can be potentially life-saving.
For hemorrhagic strokes such as the ICH strokes reviewed in this study, “there can be a sudden-onset headache, often the worst headache of the person’s life, as well as nausea, vomiting, lethargy, loss of consciousness, seizures, or neck stiffness,” Narayanan explained.
Symptoms of other types of strokes can include issues with balance, facial drooping, and slurred speech.
“It’s critical to call 911 if you think you or a family member is having a stroke, even if symptoms are improving. You never know if the stroke symptoms will recur or worsen — potentially catastrophically — en route to the hospital,” said Narayanan.
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