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Statins May Help Prevent One Type of Stroke

Stroke is a leading cause of death in the U.S., and is a major cause of serious disability for adults, according to the Centers for Disease Control and Prevention (CDC). Currently, more than 20 percent of Americans take cholesterol-lowering drugs known as statins to lower their risk of a first heart attack or stroke due to a blood clot.

So our primary care doctors in Delray Beach were pleased to hear of a new study showing that statins may also help decrease the risk of a first stroke as a result of an intracerebral hemorrhage, the most deadly type of stroke.

Published last month in the journal Neurology, researchers found that—after adjusting for such factors as high blood pressure, diabetes, and alcohol use—those who took statins had a 16 percent lower risk of this type of stroke following short-term use and up to a 38 percent lower risk if they had been taking the drug for five years or more.

Dangerous Bleeding

Also known as “bleeding” stroke, intracerebral hemorrhages comprise between 15-30 percent of strokes, according to the American Association of Neurological Surgeons (AANS), and are the second most common form of stroke.

The AANS explains that in an intracerebral hemorrhage, “Blood vessels carry blood to and from the brain. Arteries or veins can rupture, either from abnormal pressure or abnormal development or trauma.

“The blood itself can damage the brain tissue. Furthermore, the extra blood in the brain may increase the pressure within the skull (intracranial pressure [ICP]) to a point that further damages the brain.”

That’s why it’s important to pay attention to the possible signals of stroke and have it treated immediately. In the first three hours following a stroke, the volume of blood released increases in at least 33 percent of cases, affecting the patient’s chance for full recovery: the bigger the hemorrhage, the worse the outcome, the AANS explains.

Symptoms depend on the location of the hemorrhage and can include:

-headache, nausea, vomiting
-alterations in levels of consciousness
-weakness/numbness in the face, arm, or leg (usually on one side)
-vision loss
-seizures

The Study

“While statins have been shown to reduce the risk of stroke from blood clots, there has been conflicting research on whether statin use increases or decreases the risk of a person having a first intracerebral hemorrhage,” study author Dr. David Gaist, of the University of Southern Denmark in Odense, said in a news release.

“It’s reassuring news for people taking statins that these medications seem to reduce the risk of a bleeding stroke as well as the risk of stroke from blood clots,” he said. “For our study, we looked at the lobe and non-lobe areas of the brain, to see if the location was a factor for statin use and the risk of a first intracerebral hemorrhage,” Gaist said. “We found that those who used a statin had a lower risk of this type of bleeding stroke in both areas of the brain. The risk was even lower with long-term statin use.”

For this latest study, researchers reviewed the health records of 989 people in Denmark who had had an intracerebral hemorrhage in the lobe area of the brain and 1,175 people who had one in other parts of the brain. The lobe area includes most of the cerebrum, such as the frontal, parietal, temporal, and occipital lobes. The non-lobe area of the brain includes the basal ganglia, thalamus, cerebellum, and brainstem.

The researchers compared this group against the health records of more than 88,000 people who did not have a bleeding stroke. Those who had used statins for any length of time showed a 17 percent lower risk of this type of stroke in the lobe areas and a 16 percent lower risk of an intracerebral hemorrhage in the non-lobe areas.

People who had taken statins for more than five years had a 33 percent lower risk of a bleeding stroke in the lobe areas and a 38 percent lower risk in the non-lobe areas.

Good News

This study further confirms the efficacy of prescribing statins for those at high risk of heart disease. This includes those who:

have clinical atherosclerotic cardiovascular disease (ASCVD), including those with a personal history of stroke, heart attack, or peripheral vascular disease, and also those who suffer from chest pain (angina)
have extreme elevations in cholesterol (an LDL cholesterol of 190 mg/dL or higher)
are age 40-75 and have diabetes
are age 40-75 and have an estimated 10-year risk of an ASCVD event greater than 7.5 percent

Statins have been the subject of controversy for years because of the drugs’ perceived side effects. Some said they outweighed the benefit derived from taking them.

But Dr. Pooja Khatri, a professor and division chief of neurology and rehabilitation medicine at the University of Cincinnati College of Medicine told CNN that this latest study should help patients feel more comfortable when their doctors prescribe a statin medication.

“Studies like this latest one sort of put the nail in the coffin because they’re larger and they’re so comprehensive and population-based,” she said.

“This study tells me that if a patient has never had a stroke and they have indications, a statin is definitely a good idea. It makes us think that we are right to be certain that overall, patients are better off on statins.”

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