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Posted by on Mar 28, 2021 in Stroke | 0 comments

In a nutshell

This study investigated the effect of low-density lipoprotein cholesterol (LDL-C) levels on hemorrhagic stroke risk. Researchers suggested that the use of intensive cholesterol-lowering therapy is not associated with an increased risk of hemorrhagic stroke.

Some background

A stroke might happen due to a blood clot (ischemic) or a burst blood vessel (hemorrhagic). There is a blockage of the blood flow to the brain and thus of a lack of oxygen. Without oxygen, brain cells begin to die which results in symptoms such as paralysis. An ischemic stroke can happen if cholesterol builds up on blood vessels. This helps a small blood clot block the blood vessel. In order to prevent an ischemic stroke, patients commonly receive cholesterol-lowering medications.

Hemorrhagic strokes include 10 to 20% of all strokes and are associated with high mortality rates. A few studies have found that very low levels of LDL-cholesterol ("bad" cholesterol) might increase the risk of hemorrhagic stroke. Prior studies did not find an association between hemorrhagic stroke risk and LDL-C levels below 70 mg/dL. However, the effect of LDL-C as low as below 55 mg/dl, as is recommended by the treatment guidelines, is still unknown.

Methods & findings

This study reviewed 8 other studies with information about 122.802 patients. Of these, 62.526 patients were treated with intensive cholesterol-lowering therapies to achieve LDL-cholesterol levels below 55 mg/dl. 60.276 patients received a control therapy.

No difference was seen in the occurrence of hemorrhagic stroke between the group who received more intensive LDL-cholesterol lowering therapy (levels under 55 mg/dL) and less intensive treatment. 

The bottom line

This study concluded that an LDL-cholesterol level of under 55 mg/dl is not associated with an increased risk of hemorrhagic stroke.

The fine print

This study analyzed very different trials, with different protocols. Cholesterol-lowering medications used were different. The follow-up period was also different among trials. This might have influenced the results.

Published By :

Journal of stroke and cerebrovascular diseases: the official journal of the National Stroke Association

Date :

Feb 08, 2021

Original Title :

LDL-C Levels Below 55 mg/dl and Risk of Hemorrhagic Stroke: A Meta-Analysis.

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