The Role of Lipid-Lowering Therapy in Post-Stroke Patients: Update and Recommendations

Curr Atheroscler Rep. 2023 Nov;25(11):889-898. doi: 10.1007/s11883-023-01159-2. Epub 2023 Oct 26.

Abstract

Purpose of review: Stroke is the second leading cause of death and disability-adjusted life years worldwide, and the global lifetime risk of stroke is rising. Moreover, patients with a prior stroke are at high risk of recurrent events. We aimed at reviewing the evidence supporting aggressive secondary prevention strategies for lipid-lowering treatment in this population.

Recent findings: Statins are the key players in such aggressive management; however, stroke survivors remain at significant residual risk suggesting the need for both better implementation of statin use as well as additional lipid lowering therapies. Newer drugs have become available and represent important tools in the management of patients with prior ischemic stroke. The role of lipid lowering treatment in hemorrhagic stroke is more controversial, given epidemiological data linking low lipid levels with increased risk of first and recurrent events. Aggressive secondary prevention strategies, including lipid lowering treatments, have proven to mitigate the risk of recurrent events in post-stroke patients. The tools available for treating such high-risk population have expanded beyond statins, and clinicians should familiarize themselves with them.

Keywords: Lipid lowering therapy; Lipids; Novel therapies; Secondary prevention; Statins; Stroke.

Publication types

  • Review

MeSH terms

  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Lipids
  • Risk Factors
  • Secondary Prevention
  • Stroke* / drug therapy
  • Stroke* / prevention & control

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids