Latest HPS data reveal benefits of statins on stroke in detail
Latest data from the Medical Research Council/British Heart Foundation Heart Protection Study (HPS) show the beneficial effects of statins on stroke are almost entirely restricted to the most common, ischaemic form of the disease — currently responsible for about nine out of 10 strokes in the UK.
The data show that a daily 40mg dose of simvastatin lowers the risk of
ischaemic stroke by 28 per cent in men and women with arterial disease
or diabetes (Lancet 2004;363:757). It also reduces their risk of transient
ischaemic attack and need for carotid endarterectomy or angioplasty.
Treatment has no effect on haemorrhagic stroke and, although it reduces
overall vascular events by 20 per cent in patients with pre-existing
cerebrovascular disease, it does not affect their overall risk of stroke.
Earlier reports on HPS have estimated that, irrespective of baseline
cholesterol levels, simvastatin 40mg reduces heart attacks and strokes
by about a third in high-risk individuals who already have evidence of
coronary or other occlusive arterial disease (ibid, 2002;360:7), and
by a similar amount in people with diabetes (ibid, 2003;361:2005). The
latest paper provides a more detailed breakdown of the beneficial effects
of statin treatment on stroke. It shows that the reduction in stroke
becomes significant by the end of the second year of treatment, and that
the benefits are seen at all ages and at all blood pressure and lipid
levels (including pre-treatment LDL-cholesterol at 3mmol/L).
In HPS, over 20,000 UK adults aged 40-80 years, including 3,280 with
cerebrovascular disease, were randomised to simvastatin 40mg daily or
placebo for five years. A
total of 1,029 strokes were recorded during the study — far more
than in any previous cholesterol-lowering trial. |
The
Pharmaceutical Journal