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

International Journal of Stroke

Volumn 5, Issue 3, 2010, Pages 209-216

  Hankey, Graeme J ^a   Wong, Ka S L ^b   Chankrachang, Siwaporn ^c   Chen, Christopher ^d   Crimmins, Denis ^e   Frayne, Judith ^f   Kim, Jong S ^g   Li, Yansheng ^h   Liou, Chia Wei ⁱ   Merican, Julia S ^j   Misbach, Jusuf ^k   Navarro, Jose ^l   Shinohara, Yukito ^m   Wang, Yongjun ⁿ   Yoon, Byung Woo ^o  

^a ROYAL PERTH HOSPITAL   (Australia)

^b CHINESE UNIVERSITY OF HONG KONG   (Hong Kong)

^c CHIANG MAI UNIVERSITY   (Thailand)

^d NATIONAL UNIVERSITY OF SINGAPORE   (Singapore)

^e Central Coast Neurosciences Research   (Australia)

^f ALFRED HOSPITAL   (Australia)

^g University of Ulsan College of Medicine   (South Korea)

^h SHANGHAI JIAO TONG UNIVERSITY SCHOOL OF MEDICINE   (China)

ⁱ CHANG GUNG UNIVERSITY COLLEGE OF MEDICINE   (Taiwan)

^j Prince Court Medical Centre ^*  (Malaysia)

^k UNIVERSITY OF INDONESIA   (Indonesia)

^l UNIVERSITY OF SANTO TOMAS   (Philippines)

^m Federation of National Public Service Personnel Mutual Aid Associations   (Japan)

ⁿ CAPITAL MEDICAL UNIVERSITY   (China)

^o Seoul National University Hospital   (South Korea)

more..

Author keywords

Asia; Lipids; Prevention; Risk factors; Statins; Stroke

Indexed keywords

CHOLESTEROL; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; ICOSAPENTAENOIC ACID; PRAVASTATIN; SIMVASTATIN;

ARTICLE; ASIA; CEREBROVASCULAR ACCIDENT; CLINICAL TRIAL; HUMAN; HYPERCHOLESTEROLEMIA; INCIDENCE; MIDDLE CEREBRAL ARTERY OCCLUSION; MORBIDITY; MORTALITY; PATIENT EDUCATION; PHYSICIAN; PRACTICE GUIDELINE; PREVALENCE; PRIORITY JOURNAL; RECURRENT DISEASE; RISK FACTOR; STROKE; THROMBOEMBOLISM; TRANSIENT ISCHEMIC ATTACK;

ASIA; CEREBRAL HEMORRHAGE; CHOLESTEROL; CONSENSUS; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; HYPERCHOLESTEROLEMIA; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RECURRENCE; RISK FACTORS; STROKE;

EID: 77953798267     PISSN: 17474930     EISSN: 17474949     Source Type: Journal    
DOI: 10.1111/j.1747-4949.2010.00429.x     Document Type: Article

References (49)

1. Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol 2007, 6:182-7.
2. Liu M, Wu B, Wang WZ, Lee LM, Zhang SH, Kong LZ. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol 2007, 6:456-64.
3. Thammaroj J, Subramaniam V, Bhattacharya JJ. Stroke in Asia. Neuroimaging Clin N Am 2005, 15:273-82.
4. Shinohara Y. Regional differences in incidence and management of stroke - is there any difference between Western and Japanese guidelines on antiplatelet therapy? Cerebrovasc Dis 2006, 21((Suppl. 1)):17-24.
5. Khor GL. Cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr 2001, 10:76-80.
6. Morikawa Y, Nakagawa H, Naruse Y. Trends in stroke incidence and acute case fatality in a Japanese rural area: the Oyabe study. Stroke 2000, 31:1583-7.
7. Zhao D, Liu J, Wang W. Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing Project. Stroke 2008, 39:1668-74.
8. Morimoto K, Takeshita T. Relations between lifestyles and lifestyle-related diseases. Asian Med J 2000, 43:460-9.
9. Kim YD, Choi HY, Cho HJ. Increasing frequency and burden of cerebral artery atherosclerosis in Korean stroke patients. Yonsei Med J (in press)
10. Woodward M, Martiniuk A. Elevated total cholesterol: its prevalence and population attributable fraction for mortality from coronary heart disease and ischemic stroke in the Asia-Pacific region. Eur J Cardiovasc Prev Rehabil 2008, 15:397-401. Asia Pacific Cohort Studies Collaboration
11. Lewington S, Whitlock G. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet 2007, 370:1829-39. Prospective Studies Collaboration
12. Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol 2003, 32:563-72. Asia Pacific Cohort Studies Collaboration.
13. Suh I, Jee SH, Kim HC. Low serum cholesterol and hemorrhagic stroke in men: Korea Medical Insurance Corporation Study. Lancet 2001, 357:922-5.
14. Ebrahim S, Sung J, Song YM, Ferrer RL, Lawlor DA, Davey Smith G. Serum cholesterol, haemorrhagic stroke, ischemic stroke, and myocardial infarction: Korean national health system prospective cohort study. BMJ 2006, 333:22-5.
15. Wong LK. Global burden of intracranial atherosclerosis. Int J Stroke 2006, 1:158-9.
16. Sacco RL, Kargman DE, Gu Q, Zamanillo MC. Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study. Stroke 1995, 26:14-20.
17. Wong KS, Ng PW, Tang A. Prevalence of asymptomatic intracranial atherosclerosis in high-risk patients. Neurology 2007, 68:2035-8.
18. Amarenco P, Labeurche J. Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol 2009, 8:453-63.
19. Amarenco P, Labreuche J, Lavallee P, Touboul PJ. Statins in stroke prevention and carotid atherosclerosis: systematic review and up-to-date meta-analysis. Stroke 2004, 35:2902-9.
20. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions. Lancet 2004, 363:757-67. Heart Protection Study Collaborative Group.
21. Amarenco P, Bogousslavsky J, Callahan A. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 2006, 355:549-59.
22. Goldstein LB, Amarenco P. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study. Neurology 2008, 70((Part 2)):2364-70. SPARCL Investigators
23. Chalela JA, Kang DW, Warach S. Multiple cerebral microbleeds: MRI marker of a diffuse hemorrhage-prone state. J Neuroimaging 2004, 14:54-7.
24. Lee SH, Bae HJ, Yoon BW, Kim H, Kim DE, Roh JK. Low concentration of serum total cholesterol is associated with multifocal signal loss lesions on gradient-echo magnetic resonance imaging: analysis of risk factors for multifocal signal loss lesions. Stroke 2002, 33:2845-9.
25. Nakamura H, Arakawa K. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet 2006, 368:1155-63. MEGA Study Group
26. Yokoyama M, Origasa H, Matsuzaki M. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007, 369:1090-8. JELIS Investigators.
27. Tanaka K, Ishikawa Y. Reduction in the recurrence of stroke by eicosapentaenoic acid for hypercholesterolemic patients: subanalysis of the JELIS trial. Stroke 2008, 39:2052-8. JELIS Investigators
28. Mok VC, Lam WW, Chen XY. Statins for asymptomatic middle cerebral artery stenosis: the regression of cerebral artery stenosis study. Cerebrovasc Dis 2009, 28:18-25.
29. Mok VC, Lam WW, Fan YH. Effects of statins on the progression of cerebral white matter lesion: post hoc analysis of the ROCAS (Regression of Cerebral Artery Stenosis) study. J Neurol 2009, 256:750-7.
30. http://www.clinicaltrials.gov/ct2/show/NCT00221104?term=statin+and+stroke&rank=1, Japan Statin Treatment Against Recurrent Stroke (J-STARS) [NCT00221104], ClinicalTrials.gov, a service of the US National Institutes of Health. Available at, (accessed 8 April 2009)
31. Choi-Kwon S, Kim JS. Lifestyle factors and risk of stroke in Seoul, Korea. J Stroke Cerebrovasc Dis 1998, 7:414-20.
32. Choi-Kwon S, Yang TH, Kim EK, Jeon MY, Kim JS. Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes. Acta Neurol Scand 1998, 98:187-92.
33. Heyden S, Heyman A, Goree JA. Nonembolic occlusion of the middle cerebral and carotid arteries: a comparison of predisposing factors. Stroke 1970, 1:363-9.
34. Kuller L, Reisler DM. An explanation for variations in distribution of stroke and arteriosclerotic heart disease among populations and racial groups. Am J Epidemiol 1971, 93:1-9.
35. Caplan LR, Gorelick PB, Hier DB. Race, sex and occlusive cerebrovascular disease: a review. Stroke 1986, 17:648-55.
36. Liao JK. Safety and efficacy of statins in Asians. Am J Cardiol 2007, 99:410-14.
37. Lee G, Bae HJ, Kim JS. State of current lipid and hypertension treatment of stroke patients in Korea: The STROKE Study. Abstract presented at: 17th European Stroke Conference (ESC); 13-16 May 2008, Nice, France
38. Kim JS, Yoon SS. Perspectives of stroke in persons living in Seoul, South Korea: a survey of 1000 subjects. Stroke 1997, 28:1165-9.
39. Crimmins D, Lalor E. Australasian Acute Stroke Guidelines 2007, National Stroke Foundation, National Health and Medical Research Council, Australia
40. Chinese experts' suggestions for preventing ischemic stroke/TIA by statins. Chin J Intern Med 2008, 47:873-5.
41. Stroke Task Force Indonesian Neurological Association, Stroke Guidelines Indonesian Neurological Association, 2007
42. http://www.stroke-crc.or.kr/popup_090513.html, Clinical Practice Guideline for Stroke: Clinical Research Center for Stroke (led by Yoon BW), Guideline endorsement from the Korean Stroke Society, Korean Neurological Association and Korean Society for Geriatric Neurology, 2009. Available at, (accessed 16 September 2009)
43. Clinical Practice Guidelines: Management of Ischemic Stroke 2006, http://www.neuro.org.my, Malaysian Society of Neurosciences., Malaysia, Malaysian Society of Neurosciences, Available at, (accessed 16 September 2009)
44. Stroke Guidelines: Guidelines for the Prevention, Treatment and Rehabilitation of Brain Attack http://www.strokesocietyphil.org, Stroke Society of the Philippines., 4th edn, Philippines, Stroke Society of the Philippines, Available at, (accessed 16 September 2009)
45. http://www.moh.gov.sg/mohcorp/uploadedFiles/Publications/Guidelines/Clinical_Practice_Guidelines/Stroke%20Booklet.pdf, Stroke and Transient Ischaemic Attacks: Assessment, Investigation, Immediate Management and Secondary Prevention. MOH Clinical Practice Guidelines 2/2009, Ministry of Health (MOH), Singapore, July 2009. Available at
46. Guideline of Management of Dyslipidemia in Stroke Patients http://www.stroke.org.tw/guideline/guideline_new.asp, Taiwan Stroke Society., Taiwan, Taiwan Stroke Society, Available at, (accessed 16 September 2009)
47. Sithisuk S, Kullavanich P, Channarong N. Guideline for Primary Prevention of Atherosclerosis 1st edn. Thailand, Sri-Mueng Printing Ltd, 2009
48. Grundy SM, Cleeman JI, Merz CNB. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation 2004, 110:227-39. for the Coordinating Committee of the National Cholesterol Education Program.
49. Shinohara Y, Yamaguchi T. Outline of the Japanese Guidelines for the Management of Stroke 2004 and subsequent revision. Int J Stroke 2008, 3:55-62.