Statins reduce the risk of one of the deadliest types of stroke, research shows
Doctors know that drugs called statins reduce the risk of stroke due to blood clot. But a new study shows that inexpensive drugs can also reduce the risk of a first stroke as a result of intracerebral hemorrhage, the deadliest type.
An intracerebral hemorrhage is when blood from an artery suddenly begins to bleed into the brain. It is the second most common cause of stroke after a blood clot, which is called an ischemic stroke.
Stroke is the leading cause of death and disability in the US US Centers for Disease Control and Prevention he says. Many can be prevented with lifestyle changes such as eating healthy, exercising and quitting smoking.
Statins are another powerful tool for stroke prevention. They work by reducing fatty deposits in the arteries and preventing them from building up to cut off blood flow to the brain. Globally, hundreds of millions of people take them to prevent heart problems or strokes.
There has been conflicting research on whether a statin can reduce the risk of a first intracerebral hemorrhage. A new study, published Wednesday in the journal Neurology, appears to put a cap on part of that debate.
The researchers used prescription data and health records from more than 88,000 people in Denmark who had no history of stroke. During the study period, 989 people (mean age 76 years) had a first bleeding stroke in the lobe area of the brain, and 1175 (mean age 75 years) had a stroke in other parts of the brain.
The researchers distinguished between lobar and non-lobar strokes so they could look for differences in strokes in different parts of the brain; non-lobar strokes are often caused by high blood pressure.
The research was partially funded by the Novo Nordisk Foundation. Pharmaceutical company Novo Nordisk produces medicines for stroke treatment, but the foundation was not involved in the study design or data interpretation, the researchers said.
People in the study who took statins for any length of time had a 17% lower risk of lobar stroke and a 16% lower risk of non-lobular stroke. When they used a statin for more than five years, they had a 33% lower risk of bleeding stroke in lobe areas and a 38% lower risk in non-lobular areas.
“It is encouraging news for people taking statins that these drugs seem to reduce the risk of bleeding stroke as well as the risk of stroke due to blood clots,” said study co-author Dr. David Gaist, a professor at the University of Southern Denmark in Odense.
However, the study has some limitations. Data on potentially important underlying conditions that could lead to stroke and other information on behaviors that could increase a person’s risk, such as smoking or drinking alcohol, were missing. Additional research would also be needed to determine whether the results would be the same in non-European populations.
AND a large ongoing trial funded by the US National Institutes of Health is trying to determine whether people on statins who are admitted to the hospital with a hemorrhagic stroke should continue using the drug or stop taking it.
Some studies have shown that people with a history of stroke due to a blood clot, called ischemic stroke, may have a higher risk of hemorrhagic stroke if they take a statin.
“There were these small exploratory randomized controlled trials that suggested the possibility of an increased risk of hemorrhagic stroke if there was a history of ischemic stroke. So that threw us off a little bit,” said Dr. Pooja Khatri, professor and Chief of Neurology and Rehabilitation Medicine at the University of Cincinnati School of Medicine. She regularly works with people who have had a stroke and was not involved in the new research.
She said this study shows what makes biological sense: Taking statins and preventing the buildup of fatty deposits in the arteries reduces the likelihood of hemorrhagic strokes.
“Studies like this latest one kind of put the nail in the coffin because they’re bigger and they’re so comprehensive and population-based. “This study tells me that if a patient has never had a stroke and has an indication, a statin is definitely a good idea,” Khatri said. “It makes us think we’re right when we’re sure that patients generally do better on statins.”