Another meta-anal- ysis of randomized trials of statins in combination with other preventive strategies that included 165792 individuals showed that each 1-mmol/L (39-mg/dL) decrease in LDL cholesterol reduction in stroke.155 Several meta-analyses also found that beneficial effects are greater with greater lipid lowering. One meta-analysis of 7 randomized, controlled trials of primary and secondary prevention reported that more intensive statin therapy that achieved an LDL cholesterol of 55 to 80 mg/dL resulted in a lower risk of stroke than less intensive therapy that achieved an LDL cholesterol of 81 to 135 mg/dL (OR, Another meta-analysis of 10 randomized, controlled trials of patients with atherosclerosis and coronary artery disease reported a significant reduction in the composite of fatal and nonfatal strokes with higher versus lower statin doses (RR, 0.86; 95% CI, 0.77 0.96).157 A meta-analysis of 22 trials involving 134537 patients assessed the association of LDL cholesterol lowering with a statin and major cardiovascular events, including stroke, according to risk categories ranging from <5% to >30% 5-year risk of a major cardiovascular event.158 The risk of major vas- cular events was lowered by 21% (95% CI, 23 29) for each 39-mg/dL reduction in LDL cholesterol. For every 39-mg/dL reduction in LDL, there was a 24% (95% CI, 5 39) reduction in the risk of stroke in participants with an estimated 5-year risk of major vascular events <10%, which was similar to the rela- tionship seen in higher-risk categories. 