More on statins and stroke

Coull BM, Johnston SC Statins: not just for the faint of heart. (editorial) Neurology 2009; 72: 684-685.

Nice discussion of statins and stroke.
"Ironclad" evidence of reduction of cvd and cva in patients treated with HMGCOA.

Chaturverdi et al. compared 2000+ patients over 65 with those under 65 in posthoc analysis of SPARCL data. They found rr of stroke in elderly group was reduced by 10 %, and in the younger group by 26 %; only the second was statistically significant. However, with reduced sample sizes the two groups were not different (go figure, ask a math guy).

For atorvastatin, there was a 1.5 % reduction in second stroke at 5 years, giving a NNT of 327 for STROKE in elderly. However, for all heart disease and stroke the reduction was 4.1 % with a NNT of 120 per year, which was highly significant and probably cost effective. No one knows if simvastatin is better but it is cheaper. Authors urge use of a HIGH DOSE statin.