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Doctors know that drugs called statins reduce the risk of a stroke from a blood clot. But a new study shows the cheap drugs can also lower the risk of a first stroke from intracerebral hemorrhage, the deadliest type.
In an intracerebral hemorrhage, blood suddenly begins to bleed from an artery into the brain. It is the second leading cause of stroke after a blood clot, known as an ischemic stroke.
Stroke is a leading cause of death and disability in the US, says the US Centers for Disease Control and Prevention. Many can be prevented with lifestyle changes such as healthy eating, exercise, and quitting smoking.
Statins are another effective stroke prevention tool. They work by reducing fatty deposits in the arteries, preventing them from building up and cutting off the blood supply to the brain. Hundreds of millions of people around the world take them to prevent heart problems or strokes.
There has been conflicting research on whether a statin can reduce a person’s risk of having a first intracerebral hemorrhage. The new study, published Wednesday in the journal Neurology, appears to end some of that debate.
The researchers used prescription data and medical records from more than 88,000 people in Denmark who had no history of stroke. During the study period, 989 people (mean age 76) had a first bleeding stroke in the lobe of the brain and 1,175 (mean age 75) had one in the other parts of the brain.
The researchers differentiated 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 funded in part by the Novo Nordisk Foundation. The pharmaceutical company Novo Nordisk manufactures medicines for the treatment of stroke, but the foundation was not involved in the study design or the interpretation of the data, the researchers say.
People in the study who took statins for any period of time had a 17% reduced risk of having a stroke in the brain lobe areas and a 16% reduced risk of having a stroke in the non-lobular areas of the brain. If they took a statin for more than five years, they had a 33% lower risk of bleeding stroke in the lobe areas and 38% lower risk in the non-lobe areas.
“It’s reassuring news for people taking statins that these drugs appear to reduce the risk of a bleeding stroke as well as the risk of a stroke caused by blood clots,” said study co-author 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 stroke and other information about behaviors that could increase a person’s risk, such as smoking or alcohol use. Additional research would also need to be conducted to determine whether the results would be the same in non-European populations.
A large ongoing study funded by the US National Institutes of Health is trying to determine whether people who have been taking statins and are hospitalized with a hemorrhagic stroke should continue using the drug or stop taking it.
Some research suggests that people who have had a stroke due to a blood clot, called an ischemic stroke, have a higher risk of a hemorrhagic stroke if they take a statin.
“There were these small exploratory studies from randomized trials that suggested the possibility that there was an increased risk of hemorrhagic stroke if there was a history of ischemic stroke. So that upset us a bit,” said Dr. Pooja Khatri, Professor and Department Chair in Neurology and Rehabilitation Medicine at the University of Cincinnati College of Medicine. She works regularly with stroke patients and was not involved in the new research.
She said this study shows what makes biological sense: Taking statins and preventing fatty deposits in the arteries make hemorrhagic strokes less likely.
“Studies like this last one really 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. “This makes us think we’re right to believe that patients on statins are better off overall.”
