Statins help elderly as well as young after stroke

NEW YORK (Reuters Health) - Elderly people who’ve suffered a recent stroke benefit almost as much from treatment with a “statin” drug as do younger stroke patients, researchers report in the medical journal Neurology.

The cholesterol-lowering statins reduce the risk of heart disease. A study called SPARCL (for Stroke Prevention by Aggressive Reduction in Cholesterol Levels) was performed to see if statins also reduced stroke risk.

The study compared the risks and benefits of taking high-dose atorvastatin (brand name Lipitor) versus an inactive placebo for patients who had recently had a stroke or a so-called TIA, or transient ischemic attack. TIAs are sometimes called mini-strokes, but experts say the condition is far from trivial.

In the study there were about 2250 patients who were at least 65 years old and around 2500 who were younger than 65. Cholesterol levels were similar in the two age-groups at the start of the study, and levels fell to a similar degree with atorvastatin treatment.

Subsequently, the occurrence of a fatal or nonfatal stroke was reduced by 26 percent in younger subjects with atorvastatin compared to placebo, and by 10 percent in elderly subjects, Dr. Seemant Chaturvedi of the Wayne State University/Detroit Medical Center Stroke Program and colleagues report.

They also found the high-dose atorvastatin regimen was well tolerated by both younger and older subjects.

“Clinicians should strongly consider using statins post-stroke or TIA regardless of patient age,” Chaturvedi concluded in comments to Reuters Health.

The authors of a commentary published with the study note that doctors are currently less likely to prescribe statins for the elderly, “reflecting a broad perception that it is too late for such a treatment to make a difference in the elderly.”

The message from the SPARCL analysis “is clear,” the commentators conclude. “Whenever possible, stroke and TIA patients, even the elderly ones, should be given a high-potency, high-dose statin.”

SOURCE: Neurology, February 24, 2009.