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Controversies in Neurology
December 1999

Cholesterol as a Risk Factor for Stroke

Author Affiliations


Arch Neurol. 1999;56(12):1524. doi:10.1001/archneur.56.12.1524

IF ALL KNOWN risk factors for stroke were abolished, only half of strokes would be prevented. This leaves a large background of variance around any conclusion about individual risk factors. Moreover, risk factors love company. The larger the company, the worse the prognosis. Thus, it becomes difficult to identify the role of a single factor in the complex interplay of genetic and environmental components.

Demchuk and colleagues disagree with Landau in their interpretation of the large and contradictory literature associating cholesterol and stroke risk, but all agree that statins seem to work. Demchuk and colleagues consider treatment worthwhile within the limitations of current knowledge, side effects, and costs, but Landau argues that the absolute risk reduction with statins is very modest, whereas costs are not.

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