Beltrán Romero, Luis M.Vallejo-Vaz, Antonio J.Muñiz Grijalvo, Ovidio2022-07-062022-07-062021-12-02Beltrán Romero LM, Vallejo-Vaz AJ, Muñiz Grijalvo O. Cerebrovascular Disease and Statins. Front Cardiovasc Med. 2021 Dec 2;8:778740http://hdl.handle.net/10668/3744Elevated low-density lipoprotein-cholesterol (LDL-C) is a causal factor for the development of atherosclerotic cardiovascular disease (ASCVD); accordingly, LDL-C lowering is associated with a decreased risk of progression of atherosclerotic plaques and development of complications. Currently, statins play a central role in any ASCVD management and prevention strategies, in relation to their lipid-lowering action and potentially to pleiotropic effects. After coronary artery disease, stroke is the most frequent cause of ASCVD mortality and the leading cause of acquired disability, a major public health problem. There is often a tendency to aggregate all types of stroke (atherothrombotic, cardioembolic, and haemorrhagic), which have, however, different causes and pathophysiology, what may lead to bias when interpreting the results of the studies. Survivors of a first atherothrombotic ischemic stroke are at high risk for coronary events, recurrent stroke, and vascular death. Although epidemiological studies show a weak relationship between cholesterol levels and cerebrovascular disease as a whole compared with other ASCVD types, statin intervention studies have demonstrated a decrease in the risk of stroke in patients with atherosclerosis of other territories and a decrease in all cardiovascular events in patients who have had a stroke. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial demonstrated the benefit of high doses of atorvastatin in the secondary prevention of ischemic stroke. In this review, we discuss the evidence, use and recommendations of statins in the primary and secondary prevention of stroke, and their role in other scenarios such as the acute phase of ischemic stroke, cerebral hemorrhage, cardioembolic stroke, small vessel disease, and cognitive impairment.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/AtherosclerosisCerebrovascular diseaseLDL-cholesterolStatinsStrokeAterosclerosisTrastornos cerebrovascularesLDL-colesterolAccidente cerebrovascularMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Antimetabolites::Hypolipidemic Agents::Anticholesteremic Agents::Hydroxymethylglutaryl-CoA Reductase InhibitorsMedical Subject Headings::Chemicals and Drugs::Lipids::Lipoproteins::Lipoproteins, LDL::Cholesterol, LDLMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Secondary PreventionMedical Subject Headings::Diseases::Cardiovascular DiseasesMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathological Conditions, Anatomical::Plaque, AtheroscleroticMedical Subject Headings::Diseases::Cardiovascular Diseases::Vascular Diseases::Arterial Occlusive Diseases::Arteriosclerosis::Coronary Artery DiseaseMedical Subject Headings::Health Care::Population Characteristics::Health::Public HealthMedical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::StrokeMedical Subject Headings::Diseases::Cardiovascular Diseases::Vascular Diseases::Arterial Occlusive Diseases::Arteriosclerosis::AtherosclerosisMedical Subject Headings::Diseases::Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Intracranial Hemorrhages::Cerebral HemorrhageMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic StudiesMedical Subject Headings::Persons::Persons::Survivorsreview article34926626open access10.3389/fcvm.2021.7787402297-055XPMC8674469