Statins in stroke: prevention, protection and recovery.

Stroke is the third most common cause of death and the leading cause of neurological disability in the USA. While some risk factors for stroke, such as hypertension and cigarette smoking, are well defined, the role of cholesterol in stroke pathogenesis is debated. However, numerous studies in the past decade have shown that medications that reduce cholesterol via 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibition (statins) reduce the incidence of ischemic stroke in patients who are known to have, or be at high risk of, coronary artery disease. In addition, statins may have benefits in neuroprotection and recovery after stroke. The mechanisms by which statins protect against, and improve outcome after, stroke probably extend beyond lipid lowering.