August 25, 2010 / 9:22 PM / 9 years ago

Statin use after stroke rising slowly

NEW YORK (Reuters Health) - Most stroke patients leave the hospital with cholesterol-lowering statin drugs, a nationwide US study shows, in keeping with medical guidelines.

Still, researchers say there is room for improvement as one in six patients don’t get the drugs.

“When we have a treatment that provides such a robust benefit we definitely want all patients to get it,” said Dr. Bruce Ovbiagele, director of the Stroke Prevention Program at the University of California, Los Angeles, who led the work.

According to the Centers for Disease Control and Prevention, strokes kill about 137,000 Americans every year.

Ovbiagele said a large clinical study of stroke patients from 2006 had shown statins cut the overall risk of having another stroke by 16 percent over five years. Both the American Heart Association and the American Stroke Association recommend starting treatment in the hospital.

“We can definitely say that we need to be pushing statins” in people who have suffered strokes from blood clots, Ovbiagele told Reuters Health. He added that the evidence was less clear for the two percent of patients in whom the stroke is caused by bleeding.

The researchers, whose findings appear in the journal Stroke, studied hospital records from across the country for more than 170,000 patients.

They found statin prescriptions had climbed steadily from 76 percent to 85 percent between 2005 and 2007.

“We could do better, but this is not bad,” said Dr. Franz Messerli, who heads the hypertension program at two New York hospitals, St. Luke’s and Roosevelt.

Although he agreed statins help stroke patients, he said he didn’t see a big need to push for more use of the drugs.

“Statins are pretty innocent medicines and the downside is fairly small, but it’s not nothing,” he told Reuters Health. For instance, high-dose statins may be toxic to the liver and can cause rare cases of rapid muscle breakdown. And their long-term effect on muscle tissue is unknown.

According to the new results, statins are less commonly prescribed in the South, just as they are used less in women than in men.

“This is not unique to stroke medications,” said Ovbiagele, adding that the reasons were unclear. “Women tend to receive less prevention therapy across the board.”

Messerli said some doctors might perceive women to have a smaller stroke risk. But once they’ve had one already, he said, “this is a misconception.”

SOURCE: Stroke, July, 2010.

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