HMG-CoA reductase inhibitors in the prevention of stroke

Stroke is a heterogeneous disorder, with the definition including both haemorrhagic and ischaemic stroke. Although these subtypes of stroke have different underlying pathophysiological mechanisms, atherosclerosis plays a pivotal role in both. Most risk factors for cardiovascular disease are also ris...

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Bibliographic Details
Published in:Drugs (New York, N.Y.) N.Y.), 2000, Vol.59 (1), p.1-6
Main Authors: VAN MIL, A. H. M, WESTENDORP, R. G. J, BOLLEN, E. L. E. M, LAGAAY, A. M, BLAUW, G. J
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cholesterol - blood
General and cellular metabolism. Vitamins
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Medical sciences
Pharmacology. Drug treatments
Risk Factors
Stroke - etiology
Stroke - prevention & control
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Summary:Stroke is a heterogeneous disorder, with the definition including both haemorrhagic and ischaemic stroke. Although these subtypes of stroke have different underlying pathophysiological mechanisms, atherosclerosis plays a pivotal role in both. Most risk factors for cardiovascular disease are also risk factors for stroke. Patients with a history of cardiovascular events are at an increased risk of stroke. Although hypercholesterolaemia is the most characteristic risk factor for atherosclerotic diseases, recent data suggest that the correlation between cholesterol levels and either ischaemic or haemorrhagic stroke is weak. However, the interpretation of these results is hampered by the inconsistent use of classifications of the various subtypes of stroke in studies. Pooled data on the effect of HMG-CoA reductase inhibitors show a 30% risk reduction in strokes. These beneficial effects are obtained from studies in middle aged patients with ischaemic heart disease, the interpretation being that the effects of HMG-CoA reductase inhibitors on stroke are mediated via (i) cholesterol-lowering effects on the coronary vasculature or (ii) cholesterol-independent effects of these agents. The results cannot be extrapolated to the elderly, among whom stroke most frequently occurs.
ISSN:0012-6667
1179-1950
DOI:10.2165/00003495-200059010-00001