Patients with unresolved increased cholesterol levels are treated with statins. Increased levels of non-fasting triglycerides are associated with a higher risk for ischemic stroke in men and women. Increasing cholesterol levels are also associated with an increased risk for ischemic stroke in men only, not in women. The focus so far on lowering cholesterol levels does not completely reduce the risk of atherosclerotic events, including myocardial infarction and stroke, unless triglyceride levels are also reduced, suggesting that other lipids may also play a role in the pathogenesis of atherosclerosis. Researchers found that as the levels of non-fasting triglycerides increased, so did the risk for ischemic stroke. After adjustment for age, hypertension, smoking, alcohol consumption, atrial fibrillation, lipid-lowering therapy, and in women hormone replacement therapy and menopausal status, the researchers found that women with a non-fasting triglyceride level above 445 mg/dL (5 mmol/L) had a 4-fold increased risk for stroke compared with women with a non-fasting triglyceride level below 90 mg/dL (1 mmol/L). The corresponding risk in men was a 2.3-fold increased risk. Researchers also found that increasing cholesterol levels were not associated with risk for ischemic stroke in women. However, men with cholesterol levels of 348 mg/dL (9.00 mmol/L) or greater had almost a 4.5-fold increased risk for ischemic stroke (hazard ratio, 4.4: 95% confidence interval, 1.9 – 10.6), compared with men with cholesterol levels less than 5.00 mmol/L. Desirable levels of triglycerides are below 18 to 200 mg/dL (2 mmol/L). Patients should attempt to reach ideal triglyceride goals through lifestyle changes, which include weight loss; reduction of intake of saturated fatty acids, cholesterol, and alcohol; cessation of smoking; and increased physical exercise, and if need be, statin medication (lipitor or crestor) if triglyceride levels remain above 200 mg/dL after 3 months of lifestyle changes. Taken from Ann Neurol. Published online.