Effective lipid-lowering therapy, regardless of type, reduces strokes in patients with coronary heart disease, according to an article in the March 24th issue of The Archives of Internal Medicine. The reduction in risk for stroke appears to be maximal when total cholesterol is lowered to less than 230 mg/dL.

According to information given in the article, the association between reduced blood cholesterol levels and decreased risk for coronary heart disease had been clear prior to the current study, but it was uncertain whether the same association existed for risk of stroke. Previous studies had focused specifically on statin use and had found that reductions in cholesterol might reduce stroke incidence.

In the current study, Philippe Lechat, M.D., Ph.D., and his French colleagues investigated the general effects of lipid-lowering therapy on stroke prevention. The researchers performed a literature search from 1966 to 2001 and analyzed randomized trials of primary and secondary coronary heart disease prevention, testing statins, non-statin drugs, diet, or other interventions that provided data on stroke incidence.

The researchers' analysis of 38 trials and 83,161 patients showed a significant relative reduction (17 percent) in risk for strokes with effective lipid-lowering therapy --- an effect seen regardless of type of therapy and of use as primary or secondary prevention. The most substantial effects were obtained with statins, use of which was associated with a 26 percent relative risk reduction. Additional analysis showed a significant correlation between risk of stroke and total cholesterol levels.

"The results of this meta-analysis provide strong evidence in favor of the potential of lipid-lowering therapies to prevent stroke," wrote the authors. "Such preventive effect appears related to efficacy of lipid-lowering therapy to lower blood cholesterol levels, explaining why the most convincing results were obtained with statins. Indeed, optimal prevention appears to be obtained when cholesterol level is lowered to less than 232, g/dL."