The consistency of these findings suggests that using current drugs to lower cholesterol, in fact, can prevent ischemic stroke. On a population basis, it is interesting to note a reduction in stroke incidence in Japanese populations at a time when a modest raising of blood cholesterol was occurring from changes in the traditional Japanese diet. This finding may support the assertion that the two different kinds of stroke respond differently to cholesterol interventions. However, direct clinical trials of cholesterol-raising in persons with low cholesterol levels have not been undertaken. Summary The relationship between stroke and blood cholesterol levels is complex.
Stroke is really two or more related diseases of different causes and pathologies.
Low blood cholesterol levels appear to be associated with defects in the cerebral arterial walls, probably worsened by high blood pressure and possibly by excessive alcohol consumption. Hemorrhagic strokes, while more severe, make up only about 17 percent of all strokes. The selective treatment of hypercholesterolemic patients would have to include stroke prevention as one of its benefits, albeit smaller than its benefit from coronary disese prevention. Recommendations High blood pressure control and smoking cessation remain major risk factor modifications likely to reduce stroke incidence and mortality. The reduction of dietary fat, saturated fat and cholesterol continues to be the primary means to lower blood cholesterol levels on a population basis.