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Low serum cholesterol as a risk factor for hemorrhagic stroke in men: a community-based mass screening in Okinawa,
K Okumura1, K Iseki, K Wakugami
1Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan.
Insights
Lower serum cholesterol levels were found to be an independent predictor of cerebral hemorrhage in men. This study examined the relationship between total serum cholesterol and stroke subtypes in a Japanese community.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Epidemiology
Background:
- The association between total serum cholesterol and stroke risk remains debated.
- Understanding cholesterol's role in different stroke subtypes is crucial for public health.
Purpose of the Study:
- To investigate the relationship between serum total cholesterol levels and various stroke subtypes.
- To identify potential predictors of stroke within a Japanese community-based screening program.
Main Methods:
- A cohort of 38,053 participants from a 1983 mass screening in Okinawa, Japan, was followed for stroke incidence from 1988 to 1991.
- Serum total cholesterol levels were measured at baseline.
- Stroke cases (n=315) were categorized into cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage, and others.
Main Results:
- In men, lower serum cholesterol (< or =167 mg/dl) was independently associated with an increased odds ratio for cerebral hemorrhage (OR=0.73, 95% CI 0.56-0.96 for > or =218mg/dl vs < or =167 mg/dl).
- The overall odds ratio for cerebral hemorrhage in men was 0.71 (95% CI 0.55-0.95).
- No significant association was found for cerebral infarction or subarachnoid hemorrhage with cholesterol levels.
Conclusions:
- Lower serum cholesterol levels are an independent predictor of cerebral hemorrhage in men.
- These findings suggest a complex relationship between cholesterol and stroke subtypes, particularly in men.
- Further research is warranted to elucidate the mechanisms underlying this association.
Abstract:
The relation between the level of total serum cholesterol and stroke is controversial. The relation between serum total cholesterol and subtypes of stroke was examined in the participants of a community-based mass screening program in Okinawa, Japan. A total of 38,053 subjects, whose serum level of cholesterol had been determined during a mass screening carried out in 1983, were examined to see whether they had experienced stroke during a 3-year period from 1988 to 1991. Of them, 315 subjects aged 33-93 years (174 men, 141 women) had had a stroke during that period. The types of stroke were cerebral infarction in 164, cerebral hemorrhage in 111, subarachnoid hemorrhage in 19, and others in 21. In men, the odds ratio of cerebral hemorrhage was 0.71 (95% confidence interval, 0.55-0.95), and the odds ratio of cerebral hemorrhage associated with serum level of cholesterol < or =167 mg/dl, 168-191 mg/dl, 192-217mg/dl, and > or =218mg/dl were 1.00 (reference), 0.70 (0.38-1.30), 0.77 (0.55-1.08), 0.73 (0.56-0.96), respectively. Lower serum cholesterol was an independent predictor of cerebral hemorrhage in men.