[The effects of statins on stroke and cardiovascular incidence in randomized, placebo-controlled trials with clinical endpoints].

In the mortality statistics behind the coronary heart disease and cancer the stroke is the third leading cause of death. The risk factors of stroke and coronary heart disease are similar, but in a recent meta-analysis (Prospective Studies Collaboration) on 450,000 patients from 45 studies didn't find close correlation between the occurrence of stroke and the cholesterol level. In the Multiple Risk Factor Intervention Trial the incidence of haemorrhagic and non-haemorrhagic stroke was analysed separately and a significant correlation has been found between the high cholesterol level and occurrence of the non-haemorrhagic stroke. The great statin trials in a large scale of patients' groups (different cholesterol and risk levels at the inclusion) beside the decline of coronary events proved a decrease in stroke incidence too. The mechanism of action of the statins on stroke is not known: beside the cholesterol lowering effect the so called pleiotropic effects (plaque stabilisation, improvement of endothelial dysfunction and antithrombotic properties) and a direct effect on vascular tone could get importance. The fact that statins could improve the incidence of coronary events with 24-34%, that of stroke with 10-31%, suggests, that this drugs has to be used more frequently in the clinical practice.