Exposure to Statin Therapy Could Lower Risk of Brain Bleeds in Older Patients

David Gaist, MD, PhD

An analysis of health record data from patients in Denmark suggests statin use was associated with a lower risk of intracerebral hemorrhage in older patients.

A nested case-control registry study of more than 2000 patients with intracerebral hemorrhage and more than 45,000 matched controls, results of the study suggest long-term statin adherence was associated with a lower risk of both non-lobar intracerebral hemorrhage and lower intracerebral hemorrhage.

“While statins have been shown to reduce the risk of stroke from blood clots, there has been conflicting research on whether statin use increases or decreases the risk of a person having a first intracerebral hemorrhage,” said study investigator David Gaist, MD, PhD, of the University of Southern Denmark in Odense and a member of the American Academy of Neurology, in a statement. “For our study, we looked at the lobe and non-lobe areas of the brain to see if location was a factor for statin use and the risk of a first intracerebral hemorrhage. We found that those who used a statin had a lower risk of this type of bleeding stroke in both areas of the brain. The risk was even lower with long-term statin use.”

Statin therapy has established itself as a cornerstone in the management of cholesterol disorders since their introduction more than 3 decades. With mountains of data illustrating the anti-inflammatory effects of statin use as well as other benefits, the overall health benefits associated with statin use has become a focal point of a multitude of research efforts. Included among these research efforts is the current study, which was conducted by Gaist and a team of colleagues from Denmark and the US.

The study, which was sponsored by Novo Nordisk, was endeavored with the specific intent of examining associations between long-term statin exposure and intracerebral hemorrhage risk based on differing intracerebral hemorrhage locations. To do so, investigators designed their suited as a nested case-control leveraging data from linked Danish registries. From within the Southern Denmark Region, investigators identified all first-ever cases of intracerebral hemorrhage occurring from 2009-2018 among people aged 55 years or older.

After identification, these patients were classified as having a lobar or non-lobar intracerebral hemorrhage and were subsequently matched for age, sex, and calendar year to general population controls. Overall, 989 patients with lobar intracerebral hemorrhage were matched to 39,500 controls and 1175 patients with non-lobar intracerebral hemorrhage were matched to 46,755 controls. The cohort of patients with lobar intracerebral hemorrhage was 52.2% female and had a mean age of 76.3 years. The cohort of patients with non-lobar intracerebral hemorrhage was 46.5% female and had a mean age of 75.1 years. Investigators pointed out logistic regression adjusted for potential confounders was used to estimate adjusted odds ratios for risk of intracerebral hemorrhage.

Upon analysis, results indicated current statin use was associated with a. Lower risk of both lobar and non-lobar intracerebral hemorrhage. When assessing duration of use, results demonstrated longer duration of use was also associated with a reduction in risk of lobar intracerebral hemorrhage, with a reduced risk observed for those with at least 1 year but less than 5 years of use (aOR, 0.89 [95% CI, 0.73-1.09]) and those using statins for 5 years or more (aOR, 0.67 [95%CI, 0.51-0.87])(P for trend =.040). A similar trend was observed for non-lobar intracerebral hemorrhage, with a greater reduction in risk associated seen for those with at least 1 year but less than 5 years of use (aOR, 0.88 [95%CI, 0.73-1.06]) and those using statins for 5 years or more (aOR, 0.62 [95%CI, 0.48-0.80])(P for trend <.001).

“It’s reassuring news for people taking statins that these medications seem to reduce the risk of bleeding stroke as well as the risk of stroke from blood clots,” Gaist added. “However, our research was done in only the Danish population, which is primarily people of European ancestry. More research should be conducted in other populations.”

This study, “Association Between Statin Use and Intracerebral Hemorrhage Location: A Nested Case-Control Registry Study,” was published in American Academy of Neurology.