Q&A

Statins prevent strokes in high-risk patients

J Fam Pract. 2004 July;53(7):522-530
Author and Disclosure Information

  • CLINICAL QUESTION: Does lipid lowering with statins prevent stroke?
  • STUDY DESIGN: Randomized controlled trial (double-blinded)
  • SETTING: Outpatient (any)
  • SYNOPSIS: This report is part of the Heart Protection Study that studied men and women aged 40 to 80 years, who had random total cholesterol levels of at least 3.5 mmol/L (135 mg/dL) and at least 1 of the following: cerebrovascular disease or coronary disease, other occlusive arterial disease, diabetes mellitus, or hypertension. All patients completed a run-in phase of simvastatin 40 mg daily. The researchers then excluded noncompliant patients and those unable to tolerate the medication.
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BOTTOM LINE

In a select group of compliant, high-risk patients, simvastatin (Zocor) slightly reduced the rate of stroke, except in those patients with known cerebrovascular disease. We would need to treat 72 patients for 4.3 years to prevent 1 stroke. (LOE=1b)

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