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High density lipoprotein cholesterol and the risk of stroke in elderly men: the Honolulu heart program

J David Curb1, Robert D Abbott, Beatriz L Rodriguez

  • 1Pacific Health Research Institute, Honolulu, HI 96817, USA. jdcurb@phrihealth.org

American Journal of Epidemiology
|July 6, 2004
PubMed

Insights

High-density lipoprotein (HDL) cholesterol is linked to a lower risk of stroke in elderly men. Higher HDL cholesterol levels were associated with a reduced incidence of thromboembolic stroke.

Area of Science:

  • Cardiovascular epidemiology
  • Geriatric medicine
  • Neurology

Background:

  • High-density lipoprotein (HDL) cholesterol is inversely associated with coronary heart disease.
  • The relationship between HDL cholesterol and stroke risk, especially in the elderly, is not well-defined.

Purpose of the Study:

  • To investigate the association between HDL cholesterol levels and the risk of stroke in elderly men.

Main Methods:

  • The study analyzed data from 2,444 elderly men (aged 71-93) from the Honolulu Heart Program.
  • HDL cholesterol levels were measured, and participants were followed for stroke incidence (thromboembolic and hemorrhagic) over several years.
  • Participants were free of stroke, coronary heart disease, and cancer at baseline.

Main Results:

  • HDL cholesterol was not associated with hemorrhagic stroke.
  • A consistent decline in thromboembolic stroke incidence was observed with increasing HDL cholesterol levels.
  • Men with low HDL cholesterol (<1.0 mmol/liter) had a nearly threefold higher risk of thromboembolic stroke compared to those with high levels (> or =1.6 mmol/liter).
  • These associations remained significant after adjusting for other risk factors and were particularly strong in men with desirable total cholesterol, hypertension, or diabetes.

Conclusions:

  • HDL cholesterol levels are inversely related to the risk of thromboembolic stroke in elderly men.
  • Further research is needed to determine if HDL cholesterol influences other stroke risk factors in this population.

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