Stroke is a common life-threatening disease, and it is the fifth leading cause of death in the United States. A stroke is caused by the lack of oxygen and nutrients to the brain due to blockage or rupture of a blood vessel.

As a result, brain cells begin to die, leading to damage or even death. According to the Centers for Disease Control and Prevention (CDC), the cost of stroke in the United States is estimated to be $34 billion annually, including direct medical costs and productivity losses.

What are statins?

Statins are a class of drugs that lower cholesterol levels in the blood. They work by inhibiting an enzyme called HMG-CoA reductase, which is responsible for producing cholesterol in the liver.

Statins reduce the production of cholesterol in the liver, leading to a decrease in low-density lipoprotein (LDL) or ‘bad’ cholesterol.

The link between cholesterol and stroke

High levels of cholesterol in the blood are a leading risk factor for stroke. Cholesterol build-up in the walls of blood vessels can lead to blockage or narrowing of the arteries that supply blood to the brain, leading to a stroke.

Therefore, reducing cholesterol levels in the blood is important in preventing stroke.

Effectiveness of statins in reducing stroke risk

Studies have shown that statins can reduce the risk of stroke by lowering cholesterol levels in the blood. In a meta-analysis of randomized controlled trials, statin therapy was associated with a 21% reduction in the risk of stroke compared to placebo.

Furthermore, the risk of stroke was more significantly reduced in patients who had a history of stroke or transient ischemic attack (TIA).

Statins and primary prevention of stroke

In addition to secondary prevention, statins have been shown to be effective in the primary prevention of stroke.

The JUPITER trial showed that in patients with no history of cardiovascular disease but with elevated levels of C-reactive protein (a marker of inflammation), statin therapy reduced the risk of stroke by 48% compared to placebo.

Recommended statin therapy for stroke prevention

The American Heart Association/American Stroke Association recommends that patients with a history of stroke or TIA should be prescribed a high-intensity statin like atorvastatin (Lipitor) or rosuvastatin (Crestor) to reduce the risk of another stroke. High-intensity statin therapy can reduce LDL cholesterol levels by more than 50%. Patients without a history of stroke or TIA but with other risk factors for stroke, such as hypertension and diabetes, should also be considered for statin therapy.

Side effects of statins

Statins are generally safe and well-tolerated drugs. However, like all medications, they can have side effects. The most common side effects of statins are muscle weakness or pain, liver damage, and gastrointestinal symptoms.

Muscle weakness or pain, also known as myalgia, is the most commonly reported side effect of statins. It affects up to 10% of patients and can be mild or severe. Liver damage is a rare but serious side effect of statins that can lead to liver failure.

Gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation are also common side effects of statins.

Conclusion

Statins are effective in reducing the risk of stroke by lowering cholesterol levels in the blood.

Patients with a history of stroke or TIA should be prescribed a high-intensity statin like atorvastatin or rosuvastatin to reduce the risk of another stroke. Patients without a history of stroke or TIA but with other risk factors for stroke should also be considered for statin therapy.

Although statins are generally safe and well-tolerated, they can have side effects, and patients should be monitored for any adverse reactions.