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For fatal stroke,the overall odds ratio associated with cholesterol- lowering interventions in 13 trials was 1.32(95%CI,0.94 to 1.86),and the odds ratio for the 10 single-intervention trials was 1.34(CI,0.91 to 1. 96).Among eight trials reporting nonfatal events,the summary odds ratio for nonfatal stroke for treated participants compared with controls was 0. 88(CI,0.70 to 1.11),and the odds ratio for total strokes was 0.98(CI,0.80 to 1.19).Among three trials using clofibrate,treatment significantly increased the risk for fatal stroke(odds ratio,2.64;CI,1.42 to 4.92)but not for nonfatal stroke)odds ratio,0.87;CI,0.61 to 1.26).Regression analysis showed no statistical association between the magnitude of cholesterol reduction and the risk for fatal stroke.Lowering serum cholesterol through modified diets or medications does not reduce stroke mortality or morbidity in middle-aged men.Clofibrate appears to increase the risk for fatal strokes,but the mechanism for this effect is unknown. |
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