Statin therapy to prevent stroke in the elderly

The incidence of stroke increases with advanced age, and improved strategies for preventing both first and second stroke in the elderly are needed. Recent trials prove that low-density lipoprotein reduction by statins in high-risk patients, including the elderly, reduces the risk of ischemic stroke. Patients with any history of cerebrovascular disease who are treated with statins have a reduced risk of coronary ischemic events and of all major vascular ischemic events, independent of patient age. Patients with recent transient ischemic attack or ischemic stroke show significantly reduced risks of both recurrent stroke and coronary events when they are treated with high-dose statin therapy. The vast majority of patients with ischemic cerebrovascular disease, most of whom are elderly, should be placed on statin drugs. However, the majority of stroke patients are not currently treated to recommended levels, and the elderly are particularly undertreated. No valid reasons exist for avoiding statins in elderly patients at risk for stroke.