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Management of cholesterol to reduce the burden of stroke in Asia: consensus statement

Authors


  • Conflict of interest: Siwaporn Chankrachang has received a study grant from Beaufour Ipsen and has served on advisory boards for Pfizer Inc., as well as a co-investigator for the following research groups: CHIMES, PERFORM, PRoFESS, and ORaCLE. Christopher Chen has received study grants from: Biomedical Research Council; Boehringer-Ingelheim GmbH; Eisai Inc.; Les Laboratoires Servier; Moleac Pte Ltd.; National Medical Research Council, Singapore; National Research Foundation; Novartis AG; sanofi-aventis; and UCB S.A. He has also received honoraria for serving on advisory boards for: Boehringer-Ingelheim GmbH; BrainsGate Ltd.; Daiichi Sankyo Co., Ltd.; Eisai Inc.; Janssen®, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.; Les Laboratoires Servier; Lundbeck Inc.; Novartis AG; sanofi-aventis; and Takeda Pharmaceutical Company, Ltd. Denis Crimmins has received honoraria for clinical presentations and lectures from Astra, Boehringer-Ingelheim GmbH, and Pfizer Inc.

Graeme J. Hankey*, Stroke Unit, Department of Neurology, Royal Perth Hospital, 197 Wellington Street, Perth 6000, Australia. E-mail: gjhankey@cyllene.uwa.edu.au

Abstract

Stroke is a major cause of morbidity and mortality in Asia, and its pattern is changing. The incidence of haemorrhagic stroke is declining while the incidence of ischaemic stroke caused by large artery atherothromboembolism is increasing secondary to an increase in the prevalence of hypercholesterolaemia. The Working Group on Stroke and Lipids Management in Asia Consensus Panel assembled leading experts from the region to reach a consensus on how to address this challenge. The group discussed the observational epidemiology of the relationship between cholesterol and risk of stroke, the clinical trial evidence base for cholesterol-lowering for stroke prevention, and issues specific to stroke and lipid management for Asian doctors and patients. Stroke guidelines from many of the Asian countries have recently recommended consideration of statins for recurrent stroke prevention in patients with previous ischaemic stroke or transient ischaemic attack. However, because these recommendations have yet to be implemented widely, there is a need to educate Asian physicians and patients about the importance of adequate control of hypercholesterolaemia. Further trials of statins in Asian patients are also needed, particularly in those with intracranial stenosis.

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