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Statins and cerebrovascular disease: new perspectives in stroke prevention

L. Castilla-Guerra, M.C. Fernández-Moreno, J.M. López-Chozas, M.D. Jiménez-Hernández [REV NEUROL 2007;44:95-100] PMID: 17236149 DOI: https://doi.org/10.33588/rn.4402.2006549

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Volumen 44 | Number 02 | Nº of views of the article 3.903 | Nº of PDF downloads 17 | Article publication date 16/01/2007

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ABSTRACT

INTRODUCTION AND DEVELOPMENT. The role played by statins in the prevention of strokes has been subject to controversy for a long time, especially because no clear correlation between levels of cholesterol in serum and strokes has yet been established. Nevertheless, a number of randomised trials with statins and several meta-analyses that were carried out later have proved that statins lower the incidence of all kinds of strokes, with a 21% reduction in the relative risk. It has also been shown that this effect is essentially due to the degree to which LDL cholesterol (cholesterol linked to low-density lipoproteins) is reduced, which has a lowering effect on lipid levels. It has also been shown that statins have others beneficial effects apart from reducing cholesterol levels and that these may be independent of the subjects basal lipid levels. We are referring to the so-called pleiotropic effects, which include stabilisation of the atherosclerotic plaque, an antiinflammatory effect, an antithrombotic effect and enhanced vasomotor reactivity. CONCLUSION. The recent appearance of the results of the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) study and the guidelines published by the American Heart Association and the Spanish Neurology Society, which grant statins a leading role in stroke prevention, both open up new horizons for the use of statins in cerebrovascular pathologies. KeywordsCarotid atheromatosis Pleiotropic effects Primary prevention Secondary prevention Statins Stroke prevention CategoriesPatología vascular Técnicas exploratorias

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