People who have had an ischemic stroke—a stroke caused by a blocked blood vessel—face a high risk of having another stroke or heart problem.
Because of this, doctors often try to lower LDL cholesterol, also known as “bad cholesterol,” to help prevent these future health issues.
A new study led by the TIMI Study Group at Brigham and Women’s Hospital has shown that reducing LDL cholesterol to very low levels could bring even more benefits than previously thought for these patients.
This large study looked at over 5,000 people who had suffered an ischemic stroke at least four weeks before joining the study.
The average age of the participants was 65, and about one-third were women. The researchers analyzed data from the FOURIER trial and its follow-up study to see how LDL cholesterol levels affected the risk of stroke and other heart problems.
The study grouped patients based on their LDL cholesterol levels. Some had very low levels—below 20 mg/dL—while others had levels over 70 mg/dL.
The researchers found that people with lower LDL levels had fewer major cardiovascular problems and fewer strokes. For example, patients with LDL cholesterol lower than 40 mg/dL had a 31% lower rate of serious heart issues compared to those with levels above 70 mg/dL. These low LDL levels were also linked to fewer repeat strokes.
One concern in past studies was that extremely low cholesterol levels might increase the risk of bleeding in the brain, known as hemorrhagic stroke. But in this study, there was no sign that very low LDL cholesterol raised this risk. Bleeding strokes were rare and not linked to cholesterol levels.
This is important because some doctors may hesitate to push LDL levels too low, worrying about side effects. These new results show that lowering cholesterol to very low levels is not only safe for people who have had a stroke, but also helpful in preventing more strokes and heart problems.
The study used data from patients who had taken medications called PCSK9 inhibitors or ezetimibe—drugs that are used when statins alone don’t lower cholesterol enough.
These treatments help people reach very low LDL cholesterol levels safely. The results from this study suggest that more intensive treatment to lower LDL could benefit stroke survivors, particularly those with other risks for heart disease.
In conclusion, this research provides strong evidence that getting LDL cholesterol below 40 mg/dL can help reduce the risk of repeat strokes and serious heart events in people who have already had an ischemic stroke.
Importantly, this can be done safely without raising the risk of bleeding in the brain. These findings may encourage doctors to aim for lower cholesterol targets in stroke survivors and could change how patients are treated in the future.
If you care about stroke, please read studies about how to eat to prevent stroke, and diets high in flavonoids could help reduce stroke risk.
For more health information, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
The study is published in Circulation.
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