Natural Statins and Stroke Risk

In the United States, ≈600 000 persons experience a clinical stroke (first or recurrent) annually.1 Although the case-fatality rate has declined over the past decades, it is still high. The annual death toll is ≈150 000, which qualifies stroke as the third leading cause of death, behind coronary heart disease (CHD) and cancer. The clinical sequelae of a stroke are often devastating. Among the more than 3 million stroke survivors, approximately one half have hemiparesis, one third are clinically depressed, one quarter cannot walk, and one sixth are aphasic.2 Stroke is the leading cause of serious disability in the United States.1 Thus, evidence of promising preventive therapies that can reduce the human and societal costs of stroke is welcome news.The burden of stroke goes well beyond those cases that are clinically recognized. New imaging techniques of the brain have revealed a remarkably high prevalence of so-called infarct-like lesions (ILLs), or silent strokes. The NHLBI-sponsored Cardiovascular Health Study obtained cerebral MRIs on 3658 men and women ≥65 years old. ILLs ≥3 mm were found in 31% of all subjects.3 Fewer than 15% of those with such lesions had a clinical history of stroke. The prevalence of ILLs increased with age; 22% of subjects 65 to 69 years old had ILLs, compared with 43% in subjects ≥80 years old. Subjects with ILLs were more likely to be hypertensive or to have a history of stroke, atrial fibrillation, or dilated cardiomyopathy. Importantly, the presence of these lesions was associated with a decline in cognitive function and impaired motor coordination. It is intriguing to speculate that the memory loss associated with aging may be due in part to unrecognized multiple ILLs, a condition that when advanced is called multi-infarct dementia. Whether brain lesions can be prevented and cognitive function …