Abstract
Dyslipidemia has been proven to play an important role in the occurrence and development of the ischemic stroke and lipid-lowering therapy could significantly decrease the risk of the ischemic stroke. However, the association between lipid levels, lipid-lowering therapy and the risk of intracerebral hemorrhage (ICH) is not clear. Studies have shown that low serum levels of total cholesterol might be associated with increasing risk of ICH, whereas the SPARCL study, a large prospective, randomized, placebo-controlled trial, demonstrated an increased risk of hemorrhagic stroke during high-dose statin therapy among the patients with previous stroke. The relationship between lipid-lowering therapy and ICH has become a hot topic in the recent years. We searched PubMed for articles published in English to review the existing evidence on the association of lipid levels, statin therapy and risk of ICH as well as the underlying mechanisms in order to provide practical recommendations for clinical decision-making and a foundation for further researches.
Highlights
Stroke is one of the leading causes of death and adult disability in the world
The results showed there was no significant association between statin use and Intracerebral hemorrhage (ICH) in the random trials, cohort studies and case–control studies
Conclusion epidemiological investigation found that the population with lower serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels had a higher risk of ICH, the reduction of blood lipid levels caused by statin therapy might not increase the risk of ICH
Summary
Stroke is one of the leading causes of death and adult disability in the world. Intracerebral hemorrhage (ICH), an important subtype of the stroke, is characterized by high mortality and morbidity, which contains symptomatic intracerebral hemorrhage (sICH) [1] and cerebral microbleed (CMB) [2]. A prospective study [12] including 58,235 Finnish participants (age range 25–74 years old) without a history of coronary heart disease and stroke demonstrated that, after further adjustment for other confounding factors, the inverse association between TC and ICH is only significant in women but not in men. A meta-analysis [19] of 19 prospective cohort studies indicated that the summary relative risk of hemorrhagic stroke for 1 mmol/L increment of HDL-C was 1.17 (95 % CI 1.02– 1.35) in a dose–response analysis, which suggested that the increased level of HDL-C may be related to a higher risk of ICH.
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