Does Hypercholesterolemia Contribute to the Development of Stroke?
Despite the epidemiological studies which failed to detect any relationship between total cholesterol levels in plasma and the risk of stroke in the elderly [Prospective Studies Collaboration, 1995; Neaton et al., 1992; Sacco et al., 1997], two series of evidence support a role for cholesterol in the development of stroke. The strongest (and unquestionable) evidence that high plasma levels of total and LDL-cholesterol contribute to the development of stroke comes from two large recent interventional studies with statins (discussed in question 6). In these two studies [Scandinavian Simvastatin Survival Study Group, 1994; Sacks et al., 1996]. a statin was administered to more than 5,000 individuals who were followed prospectively for 5 years or more. Reduction in plasma LDL-cholesterol was accompanied by a profound decrease in the incidence of CAD and, unexpectedly, to a decline to the same extent of the incidence of stroke. The second lines of evidence is provided by long-term prospecti
