Serum lipids in young patients with ischaemic stroke: a case-control study

The relation between serum lipids and ischaemic stroke remains controversial. Studies of lipid related risk factors in cerebrovascular disease have varied greatly in their findings and also in their definition of the cerebrovascular end points. Serum lipids are thought to interact with the pathogenesis of stroke through an atherosclerosis mechanism. Stroke in young patients have been shown to be related to non-atherosclerotic causes most of the time. The aim was to determine the serum lipid profile and the vascular risk factors for ischaemic stroke in a series of patients under 45 with an ischaemic stroke and to compare them with a series of controls of the same age.

Ninety four consecutive patients with ischaemic stroke were compared with 111 controls of the same age recruited from a regional electoral list. Vascular risk factors were recorded and serum lipid profile was determined in all of them.

Multivariate analyses showed that low HDL cholesterol, male sex, smoking, hypertension, and oral contraceptives were risk factors for intracerebral arterial occlusion.

Low HDL cholesterol was the only serum lipid index to be associated to an increased risk of stroke in this population. Low HDL cholesterol must be considered in the care management of young patients regardless of the detectable presence of atherosclerosis.