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Sleep Apnea, Statins, & Stroke: A Travesty?

Posted May 28 2010 6:05am

The standard of care after stroke these days is to give high-dose statins (cholesterol lowering drugs), in order to prevent a second stroke. Researchers reported that although rates of statin therapy after stoke are improving (from 75 to 85%), more needs to be done to encourage doctors to prescribe statins to everyone who suffers a stroke. This recommendation was based on the SPARCL trial , which showed that loading up on high doses of statins after an initial stroke lowered the rate of repeat strokes. If you actually read through the details, it shows that the absolute drop was 2.2% over 5 years, and 16% relative risk reduction. But despite the finding that Lipitor actually increased the risk of hemorrhagic stroke, the investigators still recommended starting statin therapy soon after a stroke or TIA.

Despite the well-intentioned recommendations by medical researchers, they're completely missing the boat. This situation reminds me of Dr. Mercola's video, The Town of Allopath . You should definitely watch this video. In summary, the town of Allopath (pun intended) had too many traffic accidents at an intersection without traffic lights. An expert was brought in from the Motor Division (MD) to determine the cause of these accidents. A town meeting was convened, and the expert proudly announced the cause of all the accidents: tire skid marks. With great enthusiasm, they decide to cover up the skid marks with Teflon, thinking that if you prevent skidding, then you won't have any more accidents. You can imagine what happens next. 

In the same way, elevated LDL cholesterol levels is only a sign of conditions that predisposes you to having a stroke. Having sleep apnea can cause liver dysfunction and altered lipid metabolism. We also know that most stroke patients have sleep apnea, and that having sleep apnea increases your chances of stroke by 2-3 times normal. I would think that screening for obstructive sleep apnea and treating it is a much more effective way of preventing second strokes.

What do you think about my recommendation? Am I going too far, or not far enough? Please enter your comments in the text box below.

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