Statins may increase risk of second hemorrhagic stroke, study suggests

Study results published in the Archives of Neurology suggest that patients given statins after suffering a hemorrhagic stroke may be at an increased risk of having another such stroke. Currently, statins are recommended to help reduce the risk of heart disease and ischemic stroke, but their benefit in patients who have had a hemorrhagic stroke is unclear.

Using a mathematical model based on data from two clinical trials, the researchers predicted that patients who had experienced a hemorrhagic stroke had a 22-percent risk of a second stroke if they are on statin therapy, compared to a 14-percent risk in patients not taking the drugs. The researchers note that the risk of recurrent stroke was particularly high in patients whose stroke was a lobar intracerebral hemorrhage and that for these patients, the risk of taking a statin outweighed any benefit from the drug.

However, for patients whose bleeding occurred deep within the brain, the researchers noted that the risk-benefit profile was more balanced. This suggests that whether or not to prescribe a statin after hemorrhagic stroke may depend on the location of the stroke in the brain. "There is a group of patients who have to think carefully about whether they are getting benefit from being on a statin," noted researcher Steven Greenberg, adding that "for some of those people, the risk of being on the medication may be greater than the risk of not being on it."

In an accompanying editorial, Larry Goldstein said the findings do not prove that statins increase the risk of subsequent stroke, but noted that in the absence of high-quality clinical trial data, the latest study results may help doctors make better decisions about which patients will benefit from statin therapy.

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