HMGCR and Stroke: Low-density lipoprotein (LDL) cholesterol-lowering is a core part of secondary stroke prevention.37 Statins, which inhibit HMG-CoA reductase, have been the mainstay of this therapeutic strategy, particularly since publication of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial (Figure 1).38 In SPARCL, high-dose atorvastatin therapy significantly reduced recurrent ischemic stroke risk in patients with non-cardioembolic stroke.