Editorials |

Statin Use and Intracerebral Hemorrhage:  Evidence for Safety in Recurrent Stroke Prevention?

Philip B. Gorelick, MD, MPH
Arch Neurol. 2012;69(1):13-16. doi:10.1001/archneurol.2011.234.
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The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or “statins,” are frequently prescribed in clinical practice for the prevention of stroke and cardiovascular disease.1 According to a nongeneric drug retail sales' report of the top 200 drugs sold in 2009, one of the statins ranked number 1 and another ranked number 14 in overall sales.2 Statins are multimechanistic drugs with lipid-lowering properties and beneficial non–lipid-lowering effects such as modification of endothelial function, inflammatory responses, atherosclerotic plaque vulnerability, and thrombus formation. Although generally well tolerated, statins may be associated with adverse events such as muscle aches, hepatitis or hepatotoxicity, myopathy, and other complications.1 Furthermore, a safety announcement from the US Food and Drug Administration recently informed the public about the risk of muscle injury in patients taking the highest approved dose of simvastatin (80 mg),3 and based on a pooled analysis of data from 5 statin trials, concern has been raised that intensive-dose statin therapy may be associated with an increased risk of diabetes mellitus.4

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