Cholesterol-Lowering Drugs Can Reduce Stroke Risk in Seniors

Cholesterol-lowering drugs such as statins and fibrates can reduce the risk of stroke by 34% in low-risk elderly patients, a French study shows.

The study suggests that, if the results are replicated, these medications might be considered for the prevention of stroke in elder people with no known history of vascular events, such as heart attacks and strokes.

"These results are compatible with the view of keeping elderly individuals on lipid-lowering drugs for longer periods of time," said Christophe Tzourio, lead author and professor of epidemiology at the French National Institute of Health and Medical Research, France.

Statistics and Study

Every year, globally, about 15 million people suffer a stroke. Around six million die from strokes and another five million are left disabled. This disability includes loss of vision and paralysis. Stroke is less common in people under 40 years. Stroke is the second leading cause of death for elderly population (aged 60 years and above).

Millions of people worldwide take statins to lower their blood levels of low-density lipoprotein - one of the five major groups of lipoproteins also known as bad cholesterol. Lipoproteins build up in blood vessels and can lead to atherosclerosis or hardening of the arteries - the leading cause of heart attacks and stroke.

However, many medicos recommend against statin for older adults because its benefits are less clear to the medical world. They recommend the drug only if the patient suffers from damaged arteries. Also, these lipid-lowering drugs have been linked to side effects including diabetes and cognitive impairment.

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Since statins are used widely among the older patients, professor Tzourio and his research team set out to see if they could shed light on the potential benefits of the drugs.

The study which began in 1999, analyzed data from interviews with 7,500 elderly residents with no known history of vascular events, such as heart attacks and strokes in Bordeaux, Dijon and Montpellier (cities in France).

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In the beginning of the study, participants were at least 65 years old, with an average age of 74. Around 27% of the people in the study took either statins or fibrates to lower the bad cholesterol.

Trained medical professionals took physical and cognitive measurements of the participants. Factors such as education, income and lifestyle were also taken into account.

During a long-term follow up of about nine years, 292 participants had a stroke and 440 experienced other cardiovascular problems. Strokes were more common among men and participants who have diabetes, obesity and high blood pressure.

Results

The study highlighted that taking cholesterol-lowering pills didn't lower the risk of vascular events, but it did lower the odds of having a stroke and from death. Reduction of stroke risk was similar in both statin and fibrate users.

The study doesn't prove that the lipid lowering pills prevent strokes, the scientists acknowledge. The authors note that the participants were richer, well-educated and followed healthier diets than the typical French person.

Opinion

Dr. Francine Welty, a cardiologist at Harvard Medical School in Boston who wasn't involved in the study said that factors other than the drugs might also have helped lower the risk of strokes.

Previous study in younger adults has shown statins may prevent a repeat stroke. Dr Welty also noted that the findings might be similar for people who've already had at least one stroke.

"I would expect a similar reduction in older adults because their risk for recurrent stroke may be even higher. However, until a randomized trial is done in older adults, we don't know for sure," Dr. Welty said.

The report was published in the British Medical Journal.

Source-Medindia