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Should You Take Statins After Your Stroke?
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Richard C Senelick, MD posted:
The introduction of statins to lower to cholesterol was a major advance in the prevention of heart attacks and death from cardiovascular events. In patients with elevated cholesterol levels, statins decreased the risk of cardiovascular events by 25-45%. They have become first line therapy in treating patients for the prevention of coronary artery disease and myocardial infarction.

Now, studies have shown that statins can reduce the risk of recurrent stroke by as much as 30-40%. This is a major advance, the ability to decrease a stroke survivor's chance of having a second stroke.

Statins work to:
? Lower the overall risk of stroke
? Slow the progression of carotid atherosclerosis
? Decrease the "stickiness" of platelets in the blood
? Decrease heart disease and myocardial infarction and therefore reduce the risk of blood clots going from the heart to the brain

Statins lower LDL or what we call "bad cholesterol." Over the last few years we have steadily lowered the ideal level for LDL in people who are at risk for stroke or have elevated LDL. It wasn't that many years ago that we aimed for a level of less than 125mg/dl. Multiple research studies have set a new goal of less than 70mg/dl, a significant adjustment from our previous thinking. The lower we drive the LDL level the greater we can reduce your risk for a stroke or myocardial infarction. We also have to remember that most stroke survivors do not die of another stroke, but die from heart disease. Therefore it is critical to focus on preventing heart disease after stroke and driving the LDL below 70mg/dl.

.After a stroke we have focused on the first line strategies to prevent another stroke: antiplatelet agents like aspirin; tight control of blood pressure and diabetes; smoking cessation, exercise and diet. Now we need to add the institution of statin therapy and other methods to lower the LDL cholesterol levels. Most physicians now add statin therapy to the discharge instructions that you receive when you leave the hospital after a stroke. An exception may be hemorrhagic strokes, an event where the stroke is caused by bleeding in the brain. Statins may be detrimental or at least of no benefit in this situation

If you have had a stroke, first adopt all the necessary lifestyle changes. But, also ask your doctor if you should be taking a statin drug and also what other measures you can take to prevent another stroke or heart attack. If you had your stroke a number of years ago, it may be time to make an appointment and see if you should be considered under the new criteria for statin therapy.
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been.  You still can achieve new goals.

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Debtn responded:
My mom was on statin drugs before her stroke & afterwards. Also on BP meds. Insulin dependent & also has graves disease(thyroid). Age 73, is trying to recover now. Because of the extent of disability, & different areas affected, My thoughts are the blood thinner heparin & anticoagulants w/ aspirin caused more damage or more small pieces of plaque to hit different areas of the brain. Also didn't have thyroid meds for 4 days, BP was high, sugar was running 300-400 after each finger stick. Any thoughts would be appreciated.


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Richard C. Senelick M.D. is a physician specializing in both neurology and the subspecialty of neurorehabilitation. He did his undergraduate and medic...More

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