ten Dam V H, Bollen E L, Westendorp R G, Meinders A E, Blauw G J
Sectie Gerontologie en Geriatrie, afd. Algemene Interne Geneeskunde, Leids Universitair Medisch Centrum, Postbus 9600, 2300 RC Leiden.
Ned Tijdschr Geneeskd. 2001 Oct 6;145(40):1918-21.
There is accumulating evidence that statins reduce stroke risk, even though total cholesterol is not a risk factor for stroke. The explanation for this discrepancy is subject to discussion. It should be realised that the beneficial effects of statins on stroke risk have only been demonstrated in a select population, i.e. middle-aged men with ischaemic heart disease. Several clinical trials are underway to examine the effects of statins on stroke risk in more characteristic groups of patients who are at increased risk of developing stroke. The results of these studies should be awaited before statins are recommended for the prevention of stroke. Recently it has been reported that statins lower the risk of developing dementia. These conclusions were drawn from two cross-sectional studies. Because of the nature of the studies, only an association between the use of statins and a lower risk of developing dementia was shown, and not a causal relationship. Experimentally-controlled studies have to be designed to investigate the effect of statins on dementia.
越来越多的证据表明,他汀类药物可降低中风风险,尽管总胆固醇并非中风的风险因素。对于这种差异的解释仍有待探讨。应该认识到,他汀类药物对中风风险的有益作用仅在特定人群中得到证实,即患有缺血性心脏病的中年男性。目前正在进行多项临床试验,以研究他汀类药物对中风风险增加的更具代表性的患者群体的影响。在推荐他汀类药物用于预防中风之前,应等待这些研究的结果。最近有报道称,他汀类药物可降低患痴呆症的风险。这些结论来自两项横断面研究。由于研究的性质,仅显示了使用他汀类药物与较低的患痴呆症风险之间的关联,而非因果关系。必须设计实验对照研究来调查他汀类药物对痴呆症的影响。