Statin therapy and stroke prevention: what was known, what is new and what is next?

Curr Opin Lipidol. 2007 Dec;18(6):622-5. doi: 10.1097/MOL.0b013e3282f19ede.


Purpose of review: Randomized trials have shown that statins may reduce the risk of primary stroke. There is no evidence however that statins can reduce recurrent stroke incidence.

Recent findings: In the SPARCL trial, patients with a recent stroke or transient ischemic attack randomized to atorvastatin 80 mg/day had a significant 16% relative risk reduction of stroke, and a 35% reduction in major coronary events compared with placebo. This was obtained despite 25% of the placebo arm patients receiving a commercially-available statin outside of the trial. Post-hoc analysis used blinded LDL-cholesterol measurements as a marker of adherence to lipid-lowering therapy. Compared with the group with no change or an increase in LDL-cholesterol (the group adherent to placebo or not taking a statin), the group with over 50% reduction in LDL-cholesterol had a significant 31% reduction in stroke. The next step is to define whether achieving LDL-cholesterol below 70 mg/dl is better than a standard dose of statin (LDL around 100-110 mg/dl) in the secondary prevention of stroke.

Summary: Statins are effective in reducing both first-ever and recurrent stroke, and this effect seems driven by the extent of LDL-cholesterol lowering.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / pharmacology
  • Anticholesteremic Agents / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Ischemic Attack, Transient / drug therapy
  • Ischemic Attack, Transient / prevention & control
  • Randomized Controlled Trials as Topic
  • Secondary Prevention
  • Stroke / drug therapy*
  • Stroke / prevention & control*


  • Anticholesteremic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors