Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke

Published: September 14, 2023

  • The brain is the body’s most cholesterol-rich organ and some have questioned whether aggressive LDL-C lowering induces abnormal structural and functional changes. The objective of this scientific statement is to evaluate contemporary evidence which either supports or refutes the conclusion that aggressive LDL-C-lowering or lipid-lowering exerts toxic effects on the brain leading to cognitive impairment/dementia or hemorrhagic stroke.
  • Although some retrospective, case control, and prospective longitudinal studies suggest that statins and LDL-C lowering are associated with cognitive impairment or dementia, the preponderance of observational studies and data from randomized trials do not support this conclusion.
  • The risk of a hemorrhagic stroke associated with statin therapy in patients without a history of cerebrovascular disease is non-significant and achieving very low levels of LDL-C does not increase that risk.