Combination of Intracerebral Haemorrhage and Familial Hypercholesterolemia in the Acute Hospital Setting – A Challenge for Statin Treatment?

It is estimated that worldwide, around 35 million people have familial hypercholesterolemia (FH). Thus, patients affected by the combination of FH and acute intracerebral hemorrhage (ICH) are not exceptional and neurologists should be prepared to encounter them. Despite a recent finding of beneficial association between statin use during hospitalization and improved outcomes, the increased risk of recurrent ICH in the long term may make clinicians avoid statins in patients with a history of ICH. However, discontinuing statins in patients with FH worsens cardiovascular outcomes and even increases all-cause mortality. Accordingly, the continuing statin treatment in an FH patient with an acute ICH is advisable.