- Middle-aged adults and older adults taking statins were at lower risk for both lobar and non-lobar intracerebral hemorrhage (ICB).
- The benefit increased with the duration of therapy.
Why this matters
- An association was uncertain based on previous research.
- The pathophysiology of lobary ICB (predominance of amyloid angiopathy) differs somewhat from that of non-lobar ICB (predominance of atherosclerosis).
Study design
- Danish population-based retrospective case-control study with persons aged ≥ 55 years:
- 989 Patients with lobar ICB and 39,500 matching control patients.
- 1.175 Patients with non-lobar ICB and 46,755 matching control patients.
- Key Outcome: ICH Risk
- Funding: Novo Nordisk Foundation
- 989 Patients with lobar ICB and 39,500 matching control patients.
- 1.175 Patients with non-lobar ICB and 46,755 matching control patients.
Key Results
- Compared to non-users, current statin users showed a significant reduction in adjusted risk of 17 % for lobar ICB and a 16 % significant reduction in adjusted risk for non-lobar ICB.
- The reduction in the risk of lobar ICB increased with duration of statin use (p for Trend = 0.040): it was <1 Year of application 11 %, for ≥ 1 to <5 years of application 11 % and at ≥ 5 years of application 33 %.
- The reduction in the risk of non-lobar ICB also increased with the duration of statin use (p for Trend = 0.001): it was <1 Year of application 0 %, for ≥ 1 to <5 years of application 12 % and at ≥ 5 years of application 38 %.
- Low- to moderate-intensity statin therapy showed a similar benefit to overall statin therapy (adjusted risk reductions of 18 % and 16 % for lobar and non-lobar ICB), but high-intensity statin therapy showed no significant protection.
- The results suggested that concomitant use of antihypertensive drugs or oral anticoagulants altered the protective effect of statin therapy.
Limitations
- The validity of the study was not sufficient to assess the effect of therapy intensity.
- Data for some potential confounding factors were limited or not available.
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