EBM Consult

Statin Use During Hospitalization for Acute Intracerebral Hemorrhage


  • The use of statins (HMG Co-A reductase inhibitors) in hospitalized patients with acute intracerebral hemorrhage is associated with reductions in all strokes, all-cause mortality, and improvement in outcomes (such as discharge home or to an acute rehab facility).
  • Stopping statins during an acute intracerebral hemorrhage has been associated with worsening outcomes and thus should not be stopped unless adverse drug reactions are occurring.


  • There was initial concern about the risk of statin use in this patient population due to some early observational data suggesting a possible inverse relationship between cholesterol levels and the risk of hemorrhagic stroke.  In addition, the SPARCL trial suggested a possible increase risk for hemorrhagic stroke with high-dose atorvastatin use.
  • As it relates to the risk of acute ischemic stroke, statins have been known to improve outcomes in this type of stroke and while they ischemic strokes differ in their primary mechanisms from intracerebral hemorrhage, they share many molecular mechanisms for secondary brain injury.

  Anthony J. Busti, MD, PharmD, FNLA, FAHA

Last Updated: June 2015

Original Studies

  • Flint AC, et al. Effect of statin use during hospitalization for intracerebral hemorrhage on mortality and discharge disposition. JAMA Neurol 2014;71(11):1364-71. PubMed
  • McKinney JS, et al. Statin therapy and the risk of intracerebral hemorrhage: a meta-analysis of 31 randomized controlled trials. Stroke 2012;43(8):2149-56. PubMed

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