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Can LIPITOR and ASPIRIN prevent second episode of STROKE?

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At the start of May I suffered a stroke and they confirmed it with an MRI. They have done multiple tests and have come up with nothing yet. Right now they have me on liptior and aspirin. i don't actually have high cholestorol. Can both of these medications prevent a second stroke? I keep reading online that aspirin does not do anything for men in preventing a second stroke. Curious what you think.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Hello.

Thank you for your query at DoctorSpring.com,.

I understand your concern.

Yes, Aspirin and Atorvastatin(Lipitor) are helpful in preventing a second stroke. Lipitor helps in secondary prevention of stroke even if you have normal cholesterol values.

I do not know where you found the information that Aspirin does not help in men, but that is NOT true. As you know, most of the information present online is usually not reviewed or verified. Hence not all of it can be true.

Aspirin, which is the most commonly used anti-platelet agent, inhibits the enzyme called cyclooxygenase, preventing platelets from aggregating. This interferes with the formation of thrombi(clots), thereby reducing the risk of stroke. The effectiveness of aspirin for preventing ischemic stroke and cardiovascular events is supported by a large number of clinical trials. These trials demonstrated that Aspirin reduced the risk of secondary stroke, MI(heart attack), or vascular death and this benefit was INDEPENDENT OF SEX, age (greater or less than 65), diabetes, or hypertension.

Be rest assured that you are receiving the right treatment. I hope that clears your doubt.

Feel free to ask queries.

Thank you.



Patient replied :

Thank you for your repsonse. I read that the un-coated aspirin work better to prevent stroke than coated aspirin. Is this true? Also, when I discharged from the hospital they had me on 20 MG a day of Lipitor. Now my doctor told me to take that only twice per week. Would you agree? And they also told me to take 81 mg aspirin after getting out of the hospital. And then my Doctor changed the aspirin regimine to 162 mg per day. Would you agree with this?


Hello.

Yes. Generally immediate release (un-coated) Aspirin is better than enteric-coated formulation at lower doses. This is more important when a quick action is desired such as immediately after a stroke. A 162 mg enteric coated Aspirin can have equivalent benefit to an 81 mg immediate release formulation on long term intake.

Standard dosage of Aspirin in secondary prevention of stroke is between 75-325 mg per day. It is adjusted based on individual patient conditions. Your doctor might have increased the dose to 162 mg if he prescribed an enteric coated formulation. So a dose of 162 mg as decided by your doctor should be good for you.

The dosage of Lipitor is adjusted based on your LDL-Cholesterol levels and your doctor must have changed the dosage accordingly.

I hope this addresses your concerns. Let me know if I can assist you any further.

Thank you.



Patient replied :

Hello, I have another question. I had blood work done at my doctors office. I got the results, but the Doctor is not in until Monday to tell me why my total cholestorol is low and what I should. I had a stroke back in May and my total cholestorol was 180. Then I got out of hospital and they put me on 20 MG of Lipitor and put me on a diet. But now my cholestorol is the following:
Cholesterol Total - 105 mg/dl HDL Cholesterol - 41 mg/dl Cholesterol/HDL Ratio - 2.6 DL Chol, Calculated - 50 mg/dl Triglycerides - 71 mg/dl Non HDL Cholestorl 64 mg/dl
Is my total cholesterol dangerous because its low? What should I do? What about my other levels?
James


Hello. Thank you for writing to us again.
I have gone through the values you send and in my opinion, your cholesterol values are definitely lower, but there is nothing alarming about it. It is better to discuss withe the physician who prescribed LIpitor for you. If i was your doctor, i will reduce the dose of lipitor to 10 mg. Apart from that, no other modification is required.
Hope this is helpful,
Regards


Patient replied :

Question, ever since my stroke I have had some syptoms of anxiety etc with palpatioins and tingling and numbness. The stroke effected the right side of my and was back in may. Tonight I started to get a dull ache in my right arm and a slight tingling sensation. Is this something that I should worry about?


Hello.
No. Dull ache and tingling could be anxiety related again. The only new symptom you have is the ache and it could be a simple muscle ache (Myalgia). You need to look for weakness of limbs, loss of sensation or speech defects indicate an impending stroke. However, you need not worry about getting a repeat stroke as long as you are regular on your medications and have a healthy lifestyle with no smoking or excessive drinking, a low fat balanced diet and regular exercise.
I hope this was helpful.
Thank you.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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