Statins and the stroke-cholesterol paradox

• Published in: Netherlands journal of medicine Vol. 60; no. 1; pp. 4 - 9
• Main Authors: VAN DE WIEL, A, GAILLARD, C. A
• Format: Journal Article
• Language: English
• Published: Alphen aan den Rijn Van zuiden 01.03.2002
• Subjects: Aged; Biological and medical sciences; Clinical Trials as Topic; Female; General and cellular metabolism. Vitamins; Humans; Hypercholesterolemia - complications; Hypercholesterolemia - drug therapy; Hypolipidemic Agents - therapeutic use; Incidence; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prognosis; Risk Assessment; Risk Factors; Stroke - epidemiology; Stroke - etiology; Stroke - prevention & control; Human; Nervous system diseases; Stroke; Prevalence; Etiopathogenesis; Cardiovascular disease; Lipids; Statin derivative; Cholesterol; Cerebral disorder; Vascular disease; Prevention; Chemotherapy; Central nervous system disease; Pharmacokinetics; Cerebrovascular disease; Antilipemic agent
• ISSN: 0300-2977; 1872-9061

Although strokes belong to the group of cardiovascular disorders, there is no clear association between LDL and/or HDL levels and 'stroke' as an entity. However, there is ample evidence that statins reduce stroke risk in selected patient groups such as survivors of myocardial infarction. This apparent paradox can be explained on the one hand by the heterogeneity of strokes as a group and on the other hand by the specific characteristics of statins. There are strong indications for a relationship between blood lipid profiles and types of stroke that have atherosclerosis as the underlying pathogenetic mechanism. Apart from their ability to reduce LDL levels significantly, statins have a number of other properties, which influence the process of atherosclerosis at various stages. Future and ongoing trials have to prove which patients at risk for stroke will benefit most from the preventive use of statins.