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Cholesterol-Lowering Drugs Don't Raise Risk Of Intracerebral Hemorrhagic Stroke: Presented at ANA

By Ed Susman

Special to DG News

CHICAGO, IL -- October 2, 2001 -- Patients who use cholesterol-lowering drugs do not increase their risk of stroke caused by intracerebral hemorrhage.

Daniel Woo, MD, assistant professor of neurology at the University of Cincinnati, in Cincinnati, Ohio, and colleagues sought to determine if patients taking cholesterol-lowering drugs might be more susceptible to the hemorrhage, which can be fatal in 45 to 50 percent of cases.

Dr. Woo, in a presentation yesterday (Oct. 1) at the 126th annual meeting of the American Neurological Association, said cholesterol levels are paradoxical when it comes to stroke.

High cholesterol has been linked to ischemic strokes, by far the most common form of cerebrovascular accident.

"However," Dr. Woo said, "ischemic strokes are also the mildest strokes from which recovery is common." On the other hand low cholesterol is associated with hemorrhagic strokes which account for about 10 to 15 percent of stroke-about 70,000 a year , he said.

His study was an attempt to determine if cholesterol reduction using drugs-known to reduce ischemic stroke-would adversely affect the hemorrhagic stroke outcome.

The researchers examined the medication histories of 190 patients who had suffered an intracerebral hemorrhage and compared them with 370 control subjects who had not had this type of stroke. The controls were recruited through a random telephone dialing procedure, validated as being able to collect a representative sample.

Dr. Woo said the researchers were surprised to find that instead of increasing the risk of hemorrhage, patients taking cholesterol-lowering drugs actually had reduced stroke risks. The researchers considered that because patients taking the drugs had high cholesterol and cholesterol is believed to protect against hemorrhage then their results could have been skewed in favor of the cholesterol-lowering medication users.

"When we examined only the patients with high cholesterol," he said, "the rate of intracerebral hemorrhage was the same whether individuals were on a cholesterol-lowering medication or not. This supports the hypothesis that high cholesterol itself may be protective. It also suggests that artificially lowering cholesterol with drugs does not give you the increased risk of intracerebral hemorrhage that someone with normal or low cholesterol has."

He said further research is warranted to examine blood levels of cholesterol in subjects rather than relying on medical records.

While most of the patients in the study were using statins as cholesterol-lowering drugs, Dr. Woo said that there were too few people to discern if one cholesterol-lowering class of drugs was superior to another.

His work was funded by the National Institute of Neurological Diseases and Stroke, a part of the National Institutes of Health, Bethesda, Maryland.

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