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Nonfasting triglycerides, cholesterol, and ischemic stroke in the general population
Anette Varbo1, Børge G Nordestgaard, Anne Tybjaerg-Hansen
1Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark.
Annals of Neurology
|February 22, 2011
Summary
High nonfasting triglycerides increase ischemic stroke risk in both men and women. Cholesterol levels showed a similar association only in men at very high levels (≥9.00 mmol/liter).
Area of Science:
- Cardiovascular epidemiology
- Preventive cardiology
- Biomarkers of cardiovascular risk
Background:
- Current stroke prevention guidelines emphasize cholesterol but lack guidance on nonfasting triglycerides.
- Understanding the role of nonfasting triglycerides in ischemic stroke risk is crucial for comprehensive prevention strategies.
Purpose of the Study:
- To compare the association of stepwise increasing levels of nonfasting triglycerides and cholesterol with the risk of ischemic stroke in the general population.
- To evaluate sex-specific differences in the association between lipid levels and ischemic stroke.
Main Methods:
- A prospective cohort study involving 7,579 women and 6,372 men from the Copenhagen City Heart Study.
- Baseline measurements of nonfasting triglycerides and cholesterol were taken between 1976-1978.
- Participants were followed for up to 33 years for the incidence of ischemic stroke, with complete follow-up.
Main Results:
- Stepwise increasing levels of nonfasting triglycerides were significantly associated with an elevated risk of ischemic stroke in both women and men.
- In women, hazard ratios for ischemic stroke increased with triglyceride levels, reaching 3.9 (95% CI, 1.3-11.1) for levels ≥ 5 mmol/liter.
- In men, hazard ratios for ischemic stroke also increased with triglyceride levels, reaching 2.3 (95% CI, 1.2-4.3) for levels ≥ 5 mmol/liter. Cholesterol levels were not associated with stroke risk, except in men with levels ≥ 9.00 mmol/liter (HR 4.4, 95% CI, 1.9-10.6).
Conclusions:
- Nonfasting triglyceride levels are a significant independent risk factor for ischemic stroke in both sexes.
- High cholesterol levels (≥ 9.00 mmol/liter) were associated with increased ischemic stroke risk specifically in men.
- These findings highlight the importance of considering nonfasting triglyceride levels in stroke risk assessment and prevention strategies, particularly in women.
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