Lipitor Increases Risk of Hemorrhagic Stroke in Some PatientsDec 13, 2007 | Parker Waichman LLP
Lipitor can put some people at risk for a type of stroke that is caused by bleeding in the brain, a new study has found. The discovery of this side effect suggests that doctors should carefully consider the risks and benefits of the cholesterol lowering drug before prescribing Lipitor to patients with a prior history of strokes.
Lipitor, known generically as Atorvastatin, is a member of the drug class known as statins. Lipitor was approved by the Food & Drug Administration for lowering cholesterol. Lipitor inhibits the rate-determining enzyme located in hepatic tissue that produces mevalonate, a small molecule used in the synthesis of cholesterol. This lowers the amount of cholesterol produced which in turn lowers the total amount of LDL – or bad -cholesterol.
According to an article in the Journal “Neurology”, patients taking Lipitor who had a history of stroke were more likely to suffer a hemorrhagic stroke caused by bleeding in the brain than similar patients taking a placebo. Researchers at Duke University tracked 4,731 patients who had suffered a stroke or a mini-stroke, known as a transient ischemic attack, within the previous six months. Half were treated with Lipitor and the rest got a placebo. All were followed for an average of about 4-1/2 years.
Just over 2 percent of the patients who were taking Lipitor experienced a hemorrhagic stroke -- a type of stroke in which a blood vessel breaks and there is bleeding in or around the brain -- compared to 1.4 percent of those who got a placebo. That represented about a 60% increase in the risk of hemorrhagic stroke. Other factors that also increased the likelihood that a Lipitor patient would suffer a hemorrhagic stroke, including having had a previous hemorrhagic stroke, having high blood pressure and being a man.
But the researchers also found that Lipitor provided some protection against another type of stroke. They said people treated with Lipitor had a 21 percent reduced risk for ischemic stroke, a more common variety of stroke involving a block in the blood supply to the brain.
The researchers wrote that their findings indicated that doctors have to weigh the risk and benefits of Lipitor before prescribing it. "There is a small but significant increased risk of brain hemorrhage among people who have had a previous stroke who take Lipitor, especially among those who have had a previous brain hemorrhage," lead researcher Dr. Larry B. Goldstein told US News & World Report. "If you don't have a history of stroke, then none of this matters."
The study was paid for by Pfizer Inc., the maker of Lipitor, and Goldstein is a paid consultant for the company.