Controlling cholesterol, blood pressure adds up to prevent stroke

Reaching optimal levels for cholesterol and high blood pressure in people who've had a stroke adds up to prevent a second stroke or heart attack, according to a study to be presented as part of the Late-breaking Science Program at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 – May 2, 2009. Researchers looked at four risk factors for stroke: high LDL cholesterol, low HDL cholesterol, high triglycerides, and high blood pressure. They found that for each risk factor that is controlled at the optimal level, the risk of stroke and other major cardiovascular problems goes down.

The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study involved 4,731 people who had a recent stroke or transient ischemic attack, or mini stroke. Half received the cholesterol-lowering drug atorvastatin, and half received a placebo. The participants were followed for an average of 4.9 years.

People who reached optimal levels in all four risk factors were 65 percent less likely to have another stroke as people who did not reach optimal levels on any of the risk factors. Those who reached the optimal level on three risk factors were 38 percent less likely to have another stroke, and those who reached the optimal level on two risk factors were 22 percent less likely to have another stroke. Those who reached the optimal level on only one risk factor were only two percent less likely to have another stroke than people who did not meet any of the optimal levels.

"These results show that there is a cumulative effect to lowering cholesterol and blood pressure," said study author Pierre Amarenco, MD, of Denis Diderot University and Medical School in Paris, France, and a Fellow of the American Academy of Neurology. "People need to work with their doctors to reach the optimal level on all of these risk factors."

Amarenco said prior to this study researchers knew that lowering cholesterol and blood pressure was helpful overall in preventing stroke, but did not know whether one risk factor played a stronger role than another.

The optimal levels were defined as LDL "bad" cholesterol of lower than 70, HDL "good" cholesterol of higher than 50, triglycerides less than 150, and blood pressure less than 120/80.

Source: American Academy of Neurology