UK’s Goldstein leads new scientific statement by the American Heart Association

LEXINGTON, Ky. (Sept. 14, 2023) — Larry Goldstein, M.D., chair of the University of Kentucky Department of Neurology, chaired the writing group for a newly published scientific statement. The statement was published in the American Heart Association/American Stroke Association's (AHA/ASA) peer reviewed journal Arteriosclerosis, Thrombosis, and Vascular Biology. 

Goldstein and six other authors contributed to the statement which focuses on data related to potential brain and other complications of treatments aimed at aggressive reductions in LDL-(“bad”) cholesterol, focusing on concerns about brain bleeding and cognition. These types of treatments can greatly reduce heart disease and stroke, but concerns about the risk of side effects can limit their use. 

The new statement presents the latest evidence on potential downsides of aggressive lowering of LDL-cholesterol levels with statins, PCSK9 inhibitors, and other lipid-lowering therapies, alone or in combination. The writing group reviewed research evaluating the relationship between these lipid-lowering treatments and brain bleeding, impaired cognition/dementia/Alzheimer’s Disease, and statin intolerance.

Goldstein and his colleagues review supports the view that the preponderance of the available evidence indicates that statins and other cholesterol lowering medications do not increase the risk of brain bleeding among those without a history of stroke, and that evidence suggesting a relationship with thinking problems is not strong.

“Starting or continuing any treatment program requires a close collaboration between the patient and their health care provider,” Goldstein said. “The benefits of aggressive lipid lowering in those at risk for cardiovascular disease and stroke has been clearly established through multiple clinical trials. Our review should help inform patient-health care provider discussions addressing the benefits and risks of treatment.”