Guidelines Management of cholesterol to reduce the burden of stroke in Asia: consensus statement Graeme J. Hankey 1à , Ka S. L. Wong 2 , Siwaporn Chankrachang 3 , Christopher Chen 4 , Denis Crimmins 5 , Judith Frayne 6 , Jong S. Kim 7 , Yansheng Li 8 , Chia-Wei Liou 9 , Julia S. Merican 10 , Jusuf Misbach 11 , Jose Navarro 12 , Yukito Shinohara 13 , Yongjun Wang 14 , and Byung-Woo Yoon 15 Stroke is a major cause of morbidity and mortality in Asia, and its pattern is changing. The incidence of haemorrhagic stroke is declining while the incidence of ischaemic stroke caused by large artery atherothromboembolism is increasing secondary to an increase in the prevalence of hypercholesterolaemia. The Working Group on Stroke and Lipids Management in Asia Consensus Panel assembled leading experts from the region to reach a consensus on how to address this challenge. The group discussed the observational epidemiology of the rela- tionship between cholesterol and risk of stroke, the clinical trial evidence base for cholesterol-lowering for stroke pre- vention, and issues specific to stroke and lipid management for Asian doctors and patients. Stroke guidelines from many of the Asian countries have recently recommended considera- tion of statins for recurrent stroke prevention in patients with previous ischaemic stroke or transient ischaemic attack. However, because these recommendations have yet to be Judith Frayne has received honoraria from Boehringer-Ingelheim GmbH, Eli Lilly and Company, Pfizer Inc., and sanofi-aventis. She has also served on advisory boards for Eli Lilly and Company and Pfizer Inc. Graeme J. Hankey has received honoraria for presentations at sponsored scientific symposia and consulting on advisory boards for Pfizer Inc. Yansheng Li has received honoraria for lectures from Bayer China, Eisai China, Inc., Lundbeck Inc., and Pfizer Inc. Jose Navarro has received research grants, honoraria, and travel grants from Natrapharm, Inc./Patriot Pharmaceuticals Corp., Otsuka Pharmaceuticals Co., Ltd., Pfizer Inc., and Therapharma Inc. He is also served on advisory boards for Otsuka Pharmaceuticals Co., Ltd. and Pfizer Inc. Ka Sing Lawrence Wong has received grants, honoraria, and/or served on advisory boards for Astella Pharma, Astra, Bristol-Myer Squibb, Otsuka Pharmaceuticals Co. Ltd., Pfizer Inc., and sanofi-aventis, and holds no stock in any relevant company. Jong S. Kim, Chia-Wei Liou, Julia Shahnaz Merican, Jusuf Misbach, Yukito Shinohara, Yongjun Wang and Byung-Woo Yoon have no conflicts of interest with respect to this paper. Editorial support was provided by Fred Robin of Quintiles, and was funded by Pfizer Inc. DOI: 10.1111/j.1747-4949.2010.00429.x Conflict of interest: Siwaporn Chankrachang has received a study grant from Beaufour Ipsen and has served on advisory boards for Pfizer Inc., as well as a co-investigator for the following research groups: CHIMES, PERFORM, PRoFESS, and ORaCLE. Christopher Chen has received study grants from: Biomedical Research Council; Boehringer-Ingelheim GmbH; Eisai Inc.; Les Laboratoires Ser- vier; Moleac Pte Ltd.; National Medical Research Council, Singapore; National Research Foundation; Novartis AG; sanofi-aventis; and UCB S.A. He has also received honoraria for serving on advisory boards for: Boehringer-Ingelheim GmbH; BrainsGate Ltd.; Daiichi Sankyo Co., Ltd.; Eisai Inc.; Janssen s , Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.; Les Laboratoires Servier; Lundbeck Inc.; Novartis AG; sanofi-aventis; and Takeda Pharmaceutical Company, Ltd. Denis Crimmins has received honoraria for clinical presentations and lectures from Astra, Boehringer-Ingelheim GmbH, and Pfizer Inc. Correspondence: Graeme J. Hankey à , Stroke Unit, Department of Neurology, Royal Perth Hospital, 197 Wellington Street, Perth 6000, Australia. E-mail: gjhankey@cyllene.uwa.edu.au 1 Stroke Unit, Department of Neurology, Royal Perth Hospital, Perth, Australia 2 Prince of Wales Hospital & the Chinese University of Hong Kong, Shatin, Hong Kong 3 Northern Neuroscience Center, Chiang Mai University & Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand 4 Department of Pharmacology, National University of Singapore, Singapore 5 Central Coast Neuroscience Research Group, Gosford, NSW, Australia 6 The Alfred Hospital, Melbourne, Australia 7 Asan Medical Center & University of Ulsan College of Medicine, Seoul, Korea 8 Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China 9 Chang-Gung Memorial Hospital at Kaohsiung, Chang Gung University College of Medicine, Kaohsiung, Taiwan 10 Prince Court Medical Centre, Kuala Lumpur, Malaysia 11 Department of Neurology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia 12 Philippine Heart Center & University of Santo Tomas, Quezon City, Philippines 13 Federation of National Public Service Personnel Mutual Aid Associations Tachikawa Hospital, Tokyo, Japan 14 Beijing Tiantan Hospital, Capital Medical University, Beijing, China 15 Seoul National University Hospital, Seoul, Korea & 2010 The Authors. Journal compilation & 2010 World Stroke Organization International Journal of Stroke Vol 5, June 2010, 209–216 209