Doctors know that drugs called statins reduce the risk of stroke from a blood clot. But a new study shows that inexpensive drugs can also lower the risk of a first stroke following the deadliest intracerebral hemorrhage.
An intracerebral hemorrhage occurs 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, called an ischemic stroke.
Stroke is one of the leading causes of death and disability in the United States, according to the US Centers for Disease Control and Prevention. Many can be prevented through 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 to the brain. Worldwide, hundreds of millions of people take it to prevent heart problems or strokes.
There has been conflicting research on whether a statin can reduce the risk of a first intracerebral hemorrhage. The new study, published Wednesday in the journal Neurology, appears to put some of that debate to rest.
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 (with an average age of 76) had a first hemorrhagic stroke in the lobe region of the brain, and 1,175 (with an average age of 75) had one. 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 manufactures drugs for the treatment of strokes, but the foundation was not involved in the design of the study or the interpretation of the data, according to the researchers.
People in the study who used statins for any period of time had a 17% lower risk of stroke in the lobe areas of the brain and a 16% lower risk of stroke in the lower areas of the brain. brain other than the lobes. When they used a statin for more than five years, they had a 33% lower risk of hemorrhagic stroke in lobe areas and 38% lower risk in non-lobar areas.
“It is reassuring news for people taking statins that these drugs appear to reduce the risk of hemorrhagic stroke as well as the risk of stroke due to blood clots,” said study co-author Dr. Dr David Gaist, professor at the University of Southern Denmark in Odense.
However, the study has some limitations. It lacked data on potentially important underlying conditions that could lead to a stroke and other information on behaviors that could increase a person’s risk, such as smoking or drinking alcohol. Further research would also be needed to determine if the results would be the same in non-European populations.
A large, ongoing trial funded by the US National Institutes of Health is trying to determine whether people who have taken statins and are admitted to hospital with a hemorrhagic stroke should continue using the drug or stop taking it.
Some research has suggested that people who have 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 studies outside of randomized trials that suggested the possibility that there was an increased risk of hemorrhagic stroke if there had been a history of ischemic stroke. So that kind of threw us off,” said Dr. Pooja Khatri, professor and division 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 has not been involved in the new research.
She said this study shows what makes biological sense: Taking statins and preventing fatty deposits from building up in arteries makes hemorrhagic strokes less likely.
“Studies like this 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 indications, a statin is definitely a good idea,” Khatri said. “It makes us think that we are right to be certain that on the whole, patients are better off with statins. »