Do statins prevent stroke?
Yes. The Heart Protection Study found that simvastatin reduced the risk of any stroke by 25% in more than 20,000 people (25% were women) with diabetes, or blockages in their arteries including heart disease and cerebrovascular disease (blockages in the arteries in the head and neck).14 This benefit is mainly due to a reduction in the most common type of stroke (ischemic stroke) caused by a blood clot in the arteries of the brain. Statins do not seem to reduce the risk of bleeding in the brain (hemorrhagic stroke).15 Overall, a 39 mg/dL reduction in LDL (bad) cholesterol lowers the risk of any type of stroke by 21%.14 The benefits are even greater in men and women who have already suffered a stroke or mini stroke (transient ischemic attack or TIA). If you have a stroke, you will probably be prescribed a statin even if your cholesterol levels are not very high.16
Do women with diabetes benefit from statins?
Men and women with diabetes who are considered at high risk for heart disease benefit from statins even if they do not already have heart disease, stroke, or high cholesterol. In one study of nearly 3,000 people with diabetes (32% were women) atorvastatin (10 mg) reduced the risk of stroke and heart problems including heart attack by 37%.17 Gender analysis showed that women with diabetes benefited as much as men. There were nearly 6,000 people with diabetes in the Heart Protection Study (30% were women); those treated with simvastatin were 25% less likely to die from heart disease or suffer a heart attack or stroke compared with those who got dummy pills.18 Again, women benefited just as much as men, as did people with relatively low LDL cholesterol levels (under 116 milligrams per deciliter [mg/dL]). Some of the men and women in these studies had heart disease or a history of stroke; others were considered high risk. The National Cholesterol Education Program Adult Treatment Panel III (ATP III for short) guidelines set a target LDL cholesterol of under 70 mg/dL for patients with diabetes and heart disease.19 However, it is not clear whether men and women with diabetes who are not otherwise high-risk for heart disease (usually young people without other risk factors such as high blood pressure or obesity) would benefit from taking statins.
Do statins help prevent osteoporosis?
Statins are not used to treat or prevent osteoporosis. Test tube and animal studies suggest that statins promote bone development,20 but it is not clear whether they help prevent bone fracture in people.21, 22
When researchers looked at more than 23,000 women enrolled in various studies (not necessarily statin studies), there was suggestive but not definitive evidence that women who took statins had a lower risk of hip and vertebrae fractures.23 However, in two large trials investigating the effects of statins on heart disease in more than 13,000 people (over 2,300 women), statins did not protect against hip fracture or other types of fracture in either men or women.24, 25