Wilbert S. Aronow, MD, CMD
Department of Medicine,
New York, Medical College
Department of Geriatrics and Adult Development,
Mount Sinai School of Medicine,
New York, NY, USA.
There are conflicting data regarding the association of abnormal serum lipids with stroke in older men and women.1-4 Despite these conflicting data, simvastatin and pravastatin have been demonstrated to cause a significant reduction in the incidence of stroke in older men and women with coronary artery disease (CAD) in the Scandinavian Simvastatin Survival Study,5 in the Cholesterol and Recurrent Events Trial,6-10 and in the Long-Term Intervention With Pravastatin in Ischaemic Disease Study (Table 1).11,12
Scandinavian Simvastatin Survival Study
The Scandinavian Simvastatin Survival Study was a prospective double-blind, placebo-controlled trial which randomized 4,444 men and women (2,282 of whom were 60 to 70 years of age) with CAD and hypercholesterolemia to treatment with either 20 mg to 40 mg of simvastatin daily or placebo.5 Simvastatin significantly reduced serum total cholesterol by 25% from 261 mg/dL to 196 mg/dL, serum low-density lipoprotein (LDL) cholesterol by 35% from 188 mg/dL to 122 mg/dL, and serum triglycerides by 10% from 133 mg/dL to 120 mg/dL. It significantly increased serum high-density lipoprotein (HDL) cholesterol by 8% from 48 mg/dL to 52 mg/dL.5 At 5.