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MedicationsSupplements and Vitamins home > heart center > heart a-z list > cholesterol drugs may lower stroke risk in healthy article

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TUESDAY, May 19, 2015 (HealthDay News) -- Healthy older adults who take cholesterol-lowering drugs may be cutting their risk of stroke, a new French study suggests.

The study found that when people took medications called statins or fibrates, their risk of stroke over almost a decade went down by about one-third.

But, lead researcher Dr. Christophe Tzourio, a professor of epidemiology at the University of Bordeaux and Inserm in France, doesn't think older people should start taking these drugs solely for stroke prevention.

"Our results should not be interpreted as an indication for prescribing statins or fibrates to elderly individuals. We wouldn't recommend changing medications based on the results of only one study," he said.

"The next step is to see whether we can replicate our findings or not," he added.

The report was published May 19 in the BMJ.

Statins include drugs such as Lipitor and Zocor. Fibrates, such as Bezalip and Tricor, are prescribed to patients who can't take statins or who need additional help getting their cholesterol levels down.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, "Randomized clinical trials have demonstrated that statins substantially lower the risk of heart attack and stroke, as well as overall death in men and women, with benefits that outweigh the risk."

Statins together with a healthy lifestyle are recommended in guidelines for adults at increased risk for heart attack and stroke, even when cholesterol levels are normal, he said. "Statin therapy along with maintaining a healthy blood pressure are two of the most efficacious and cost effective ways to prevent strokes," Fonarow said.

Although some experts have questioned the use of statins in adults older than 75, most studies show that statins provide benefits that outweigh the risks, regardless of a patient's age, he said.

Fonarow said that although statins have been associated with a lower risk for stroke, no such evidence has been seen for fibrates.

"Although this study also suggests there was a benefit with fibrates, most clinical trials have failed to find a meaningful benefit with fibrate therapy," he said.

For the current study, Tzourio's team collected data on nearly 7,500 French men and women, average age 74 years, with no history of heart attack or stroke when the study began.

During an average follow-up of nine years, the investigators found that those who took statins or fibrates had a one-third lower risk of stroke compared with those who didn't take them. No association, however, was found between statins and a lower risk of heart disease in this group, the researchers said.

The reduction in the risk of stroke attributed to statins did not change when the researchers took into account other factors such as age, sex, weight, blood pressure and cholesterol levels. However, because this was an observational study, the findings do not prove a cause-and-effect relationship.

"If confirmed, these results suggest that keeping patients on cholesterol-lowering drugs could lower their stroke risk," Tzourio said. "But these findings should not be interpreted as an indication for starting these drugs in older adults," he added.

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Copyright © 2015 HealthDay. All rights reserved.SOURCES: Christophe Tzourio, M.D., Ph.D., professor, epidemiology, University of Bordeaux and Inserm, France; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; May 19, 2015, BMJ

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MedicationsSupplements and Vitamins home > high blood pressure center > high blood pressure a-z list > sleep patterns and stroke risk with hypertension article

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FRIDAY, May 15, 2015 (HealthDay News) -- People with high blood pressure who sleep less than five hours or more than eight hours each night may have significantly higher odds of a stroke, new research suggests.

Analyzing data from more than 200,000 U.S. residents with high blood pressure, scientists determined that "insufficient" sleepers logging less than five hours of shuteye each night had an 83 percent increased risk of stroke compared to "healthy" sleepers who got seven to eight hours of sleep.

"Long" sleepers reporting more than eight hours of nightly sleep experienced a 74 percent higher stroke risk than healthy sleepers, according to the study.

"We were surprised, especially with the individuals reporting insufficient sleep, because most studies . . . have shown [only] a modest increase in the chances of suffering a stroke among those with short sleep duration," said study author Dr. Oluwaseun Akinseye, a resident in internal medicine at the Icahn School of Medicine of Mount Sinai Hospital in New York City.

"Our study showed much higher odds of a stroke, almost a twofold increase," Akinseye added.

Although this study found an association between sleep duration and stroke risk in people with high blood pressure, it wasn't designed to prove a cause-and-effect relationship.

Findings from the study are scheduled to be presented Friday at the American Society of Hypertension's annual scientific meeting in New York City. Research presented at scientific conferences typically hasn't been published or peer-reviewed, and results are considered preliminary.

About one-third of adults in the United States are affected by high blood pressure, the study authors said. High blood pressure, also known as hypertension, is a risk factor for stroke as well as other forms of heart disease.

About 800,000 people each year in the United States have a stroke, according to the U.S. Centers for Disease Control and Prevention (CDC). Stroke is also a leading cause of disability in the United States, according to the CDC. The vast majority of strokes are triggered by a blood clot in the brain, while the remainder occur when a blood vessel bursts.

Akinseye and his colleagues used data collected over nine years from the U.S. National Health Interview Survey of nearly 204,000 Americans with high blood pressure. Overall, the stroke risk was nearly 14 percent among "long" sleepers; 11 percent among "insufficient" sleepers; 6 percent for "short sleepers" logging five to six hours per night; and about 5 percent among "healthy" sleepers.

Results were adjusted for the presence of other health conditions; demographic factors; and behavioral factors such as smoking and physical activity, Akinseye said.

It's not clear why sleep amount is associated with stroke risk, he said. But, he added that short amounts of shuteye are linked to higher levels of cortisol -- also known as the "stress hormone" -- in the body, while long amounts of sleep are linked to the release of inflammatory chemicals.

Dr. Amy Tai, a clinical assistant professor of neurology and neurological sciences at Stanford University School of Medicine in Palo Alto, Calif., said the study results were limited because participants self-reported their sleep amounts.

"With self-reporting, it's hard to measure the quality of the sleep the patient gets," said Tai, who wasn't involved in the new research. "It's hard to tease out if there's an independent common denominator patients share that's not being captured."

Future research should include "a more reliable form of sleep recording," Tai said.

"There are monitors that measure not only sleep duration but quality," she said. "I think studies using a more objective measurement of sleep, such as remote or recordable devices, would be helpful in truly capturing objective data because self-reporting has its limitations."

It's not clear from this study if getting the right amount of sleep will bring your stroke risk down, but if you need to get more sleep, the National Sleep Foundation has some suggestions:

Avoid alcohol, cigarettes and heavy meals two to three hours before bedtime.Have regular sleep and wake times, even on the weekends.Exercise every day -- any time of day or night is fine as long as the exercise doesn't interfere with your sleep. Keep your bedroom cool -- between 60 and 67 degrees. Avoid taking naps if you have trouble sleeping at night. Put away your electronic devices before bed.

MedicalNews
Copyright © 2015 HealthDay. All rights reserved.SOURCES: Oluwaseun Akinseye, M.D., resident, internal medicine, Icahn School of Medicine, Mount Sinai Medical Center, New York City; Amy Tai, M.D., clinical assistant professor, neurology and neurological sciences, Stanford University School of Medicine, Palo Alto, Calif.; May 15, 2015, presentation, American Society of Hypertension annual meeting, New York City

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