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When know statins have revolutionised the management of coronary artery disease , why we hesitate to say the same thing for cerebro vascular disease ?
Is it because
Atherosclerosis is different in cerebrovascular disease than coronary artery disease
or Blood pressure control becomes more important in preventing stroke than lipids?
Unlike MI , Cerebro vascular system have variety of insults.
We have observed ,simple statin administration without concomitant BP reduction has absolutely no effect on stroke prevention, while in coronary prevention even if the blood pressure optimisation is less than the desired levels, significant number of MI are still prevented. The SPARCL trial was big boost for statin industry in widening the Indication for stroke prevention
Final message Does statins remain a suspect in stroke prevention ? If we accept the saying ” Data won’t lie ” . . . the suspicion about statins is a myth. High dose Atorvastatin 80mg /day should be prescribed for every one with at high risk for ischemic stroke . 
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