Aspirin + cholesterol drugs + blood pressure drugs = Less severe strokes

Taking the "triple therapy" of aspirin, cholesterol drugs, and blood pressure drugs to prevent stroke also reduces stroke severity if one occurs, according to a new study published in the April 25, 2006, issue of Neurology, the scientific journal of the American Academy of Neurology.

People who were taking all three drugs had less severe strokes, had shorter hospital stays, and were better able to function when leaving the hospital than those who were taking one, two, or none of the three drugs.

The study examined 179 people who came to the hospital within 24 hours after having a stroke. Researchers looked at how severe the strokes were, how much brain cell damage was caused by the stroke, and other factors. The participants were divided into five groups: 69 people were taking none of the three drugs; 47 people were taking aspirin only; 29 were taking aspirin and ACE inhibitors, or blood pressure drugs; 14 were taking aspirin and statins, or cholesterol-lowering drugs; and 20 people were taking all three drugs.

The study also found that even though the amount of initial brain cell damage was roughly equal, on average, among the five groups, the amount of brain cells that were still at risk of damage at the time of hospital admission was smaller among those taking all three drugs.

Lack of normal blood flow to brain cells sets off a chain reaction. Brain cells in a progressively larger area are endangered as blood flow is reduced. Quick medical treatment is the best chance to save this region of brain cells, called the penumbra.

"It's possible that these three drugs work synergistically to reduce the amount of brain tissue that is damaged in the penumbra by improving blood flow," said study author and neurologist Magdy Selim, MD, PhD, of Harvard Medical School and Co-Director of the Stroke Center of Beth Israel Deaconess Medical Center in Boston, MA. "These results need to be confirmed before this triple therapy would be recommended for all people at risk for stroke, but they are intriguing. These three drugs are commonly prescribed and well-tolerated, and could potentially have a protective effect on the brain after a stroke."

At the time of discharge from the hospital, 65 percent of the people who had been taking the triple therapy showed neurological improvement from the time they were admitted. This was compared to 45 percent of those taking aspirin plus blood pressure drugs, 43 percent of those taking aspirin plus cholesterol drugs, 38 percent of those taking aspirin alone, and 33 percent of those taking none of the drugs.

Those taking all three drugs stayed in the hospital for an average of six days, compared to seven days for those taking aspirin only and nine days for those taking none of the drugs.

Those taking all three drugs were also more likely to be classified as having no or slight disability upon leaving the hospital: 35 percent, compared to 17 percent of those taking aspirin and blood pressure drugs, 14 percent of those taking aspirin and cholesterol drugs, 11 percent of those taking aspirin alone, and 10 percent of those taking none of the drugs.

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The study was supported in part by grants from the Harvard Center for Neurodegeneration and Repair, the Doris Duke Charitable Foundation, and the National Institute of Neurological Disorders and Stroke.

The American Academy of Neurology, an association of more than 19,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system such as Alzheimer's disease, epilepsy, Parkinson disease, multiple sclerosis, and stroke. For more information about the American Academy of Neurology, visit www.aan.com.


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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