Statin drugs should be continued after stroke

People who stopped taking cholesterol-lowering drugs after being hospitalized for a stroke are at greater risk of death or dependency within three months of the stroke, according to a study published in the August 28, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.

The study found that people who stopped taking their cholesterol-lowering drugs, also called statins, while hospitalized after a stroke were 4.7 times more likely to have died or be dependent on others for their care three months after the stroke than people who kept taking the drugs.

“These results strongly support the recommendation to physicians to continue statin drugs during the acute phase of an ischemic stroke,” said study author José Castillo, MD, PhD, of the University of Santiago de Compostela in Santiago de Compostela, Spain.

Castillo said that while no protocols suggest that patients should not receive statins after a stroke, in many cases the drugs are discontinued to avoid problems that can occur when stomach content is regurgitated into the lungs. “This study clearly shows the benefits of continuing statin use,” he said.

The study involved 89 people who were already taking the cholesterol-lowering drugs at the time when they had a stroke. For the first three days after being admitted to the hospital, 46 of the people received no statin drugs and 43 received the drugs.

After three months, 27 people, or 60 percent, of the group that received no statins had either died or were disabled to the point that they could not complete their daily activities independently, compared to 16 people, or 39 percent, of the group that kept taking statins.

Previous studies have shown that people who are taking statins at the time of a stroke have less severe strokes than those who aren't taking statins.

Statins appear to do more than reduce cholesterol. They also reduce inflammation and help keep the blood from clotting, which can cause stroke. Statins also increase the release of nitric oxide, which is protective, from the cells lining artery walls.