**American Heart Association Refutes Study Suggesting Cognitive Dysfunction from LDL-C Reduction**
In a recent scientific statement, the American Heart Association (AHA) responded to studies suggesting that lowering low-density cholesterol (LDL-C) levels may lead to cognitive impairment. The AHA evaluated the evidence surrounding aggressive LDL-C reduction efforts and their potential negative effects on the brain, including cognitive function, dementia, and hemorrhagic stroke.
Addressing concerns raised by certain retrospective, case-control, and prospective longitudinal studies, the AHA stated that their findings did not support a link between statin-mediated LDL-C reduction and cognitive impairment or dementia. The AHA’s analysis, which involved an extensive review of published clinical and epidemiological studies, clinical and public health guidelines, and expert opinion, revealed no clear evidence indicating that statins cause cognitive dysfunction.
Moreover, multiple studies, some with up to a six-year follow-up period, showed no association between statin use and the development of dementia. The AHA emphasized that even in patients without a history of cerebrovascular disease, statin treatment did not significantly increase the risk of hemorrhagic stroke, nor did it pose a risk when LDL-C levels were exceptionally low.
While acknowledging the need for additional research on the potential risk of hemorrhagic stroke in patients with a history of the condition, the AHA stated that current data regarding the increased risk from lipid-lowering treatments were inconclusive. Additionally, the AHA confirmed that combination therapy involving ezetimibe, PCSK9 inhibitors, and statins did not heighten the risk of bleeding.
Highlighting the overall benefits of lowering LDL-C levels, the AHA emphasized that reduced LDL-C levels were associated with a decreased overall risk of stroke and its recurrence, primarily due to a reduction in ischemic stroke cases.
As the discussion surrounding LDL-C reduction continues, the AHA’s scientific statement serves as a valuable resource, providing reassurance and important insights into the impact of lipid-lowering strategies on cognitive health.
The American Heart Association (AHA) issued a statement encouraging people to participate in efforts to lower low density cholesterol (LDL-C) levels.
Although it is common knowledge in the medical community that the lower the LDL-C, the better, this contradicts the fact that aggressive cholesterol lowering has led to negative research results in some studies.
On the 14th, the AHA published a scientific statement regarding the effect of active LDL-C lowering on the risk of dementia and hemorrhagic stroke (doi.org/10.1161/ATV.000000000000164).
The brain is the most cholesterol-rich organ in the body. Some studies have made waves by showing that aggressively lowering LDL-C causes abnormal structural and functional changes, including cognitive function and dementia.
In particular, since it is known that cumulative total LDL-C over a lifetime has a close impact on prognosis, voices are calling for active efforts to lower LDL-C even in healthy people. LDL-C, This is a situation that needs to be resolved.
The American Heart Association issued a scientific statement refuting the findings of some studies suggesting that active LDL-C reduction causes cognitive dysfunction.
The AHA determined whether aggressive LDL-C reduction efforts were realistic by evaluating the evidence for the conclusion that they lead to toxic effects on the brain, causing cognitive impairment, dementia, or hemorrhagic stroke.
AHA researchers examined the evidence by reviewing the literature, consulting published clinical and epidemiological studies, clinical and public health guidelines, and expert opinion.
“Some retrospective, case-control, and prospective longitudinal studies suggest that lowering LDL-C with statins is associated with cognitive impairment or dementia,” the AHA said. “However, data from a variety of observational studies and randomized trials do not. does not support this conclusion,” he said.
A trend across several studies, including trials with a mean follow-up of up to 6 years, has shown no evidence that statins are associated with causing dementia.
He continued, “In patients without a history of cerebrovascular disease, the increased risk of hemorrhagic stroke associated with statin treatment is not significant,” and emphasized, “The risk is not increased even if levels LDL-C is very low.”
The AHA’s position is that data on the increased risk of hemorrhagic stroke by lipid-lowering treatment in patients with a history of hemorrhagic stroke are uncertain and that additional intensive research is needed.
The AHA explained that it found no evidence that ezetimibe, which is added as combination therapy to PCSK9 inhibitors and statins, which are effective drugs for lowering LDL-C, also increases the risk of bleeding.
“There is no indication that hemorrhagic stroke is increased in patients or groups with low lifetime LDL-C levels,” the AHA said, adding, “There is little evidence of an increased risk even at very low LDL-C levels .”
“What is clear is that lower LDL-C levels are associated with a lower overall risk of stroke and stroke recurrence, and are primarily associated with a reduction in ischemic stroke,” the AHA said. added up.
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