[BP.09.06] STATIN TREATMENT AND THE RISK OF SUBCLINICAL CEREBROVASCULAR DISEASE. (September 2017)

• Record Type: Journal Article
• Authors: Alonzo, C.; Brescacín, L.; Zurrú, M.; Guido, B.; Linares, G.; Baroni, M.; Balian, N.; Cámera, L.; Waisman, G.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000524019.80014.66
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Epidemiological studies indicate that high lipid levels increase the risk of ischemic stroke and that lipid lowering with statins reduces the incidence of ischemic stroke. However, little is known about the effect of statin treatment on subclinical cerebrovascular disease. Our objective was to evaluate the relationship between statin treatment and the presence of silent cerebrovascular lesions in a cohort of ischemic stroke patients. Design and method: Acute ischemic stroke patients were prospectively included in a multidisciplinary secondary stroke prevention program. Pre-stroke vascular risk factor profile and control were obtained from electronic medical records and the presence of silent lacunar and non-lacunar lesions, microbleeds (MB) and white matter lesions (WML) was evaluated on admission MRI. WML (periventricular –PVL- and deep white matter lesions –DWML-) were classified according to Fazekas scale (0–3) and MB, lacunar and non-lacunar infarcts were analyzed as dichotomic variables (present or absent). Results: 1327 patients (58% female, mean age 77 ± 7 years) were included between January 2009 and December 2015; 786 (59%) were receiving statins in the year before stroke. These patients were more likely to be women (63% vs 50%; p 0.0001), and to have history of hypertension (85% vs 79%; p 0.002) and chronic kidney disease (49% vs 31%; p 0.0001); they had lower prevalence of atrial fibrillation (63% vs 50%; p 0.0001). There was a direct relationship between pre-stroke statin treatment and the burden of WML and silent non-lacunar lesions (table). Figure. No caption available. Conclusions: The benefits of statins on cerebrovascular disease may be due to a combination of mechanisms. Statins lower cholesterol levels and reduce the progression of atherosclerotic plaque formation in carotid arteries, and the incidence of emboli from cardiac, aortic and carotid sites. Furthermore, statins may produce cholesterol-independent effects such as improving cerebral blood flow and reducing inflammation and oxidative stress, which could limit the size of ischemic lesions. As the world is aging, is mandatory to identify predictors of subclinical brain damage, which is related to increased risk of dementia, depression, stroke and gait disorders.