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Total and high-density lipoprotein cholesterol and stroke risk
Yurong Zhang1, Jaakko Tuomilehto, Pekka Jousilahti
1First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China. zhangyurong72@163.com
Stroke
|April 13, 2012
Summary
High total cholesterol increases stroke risk in men, while high HDL cholesterol and low total/HDL ratio are linked to stroke risk in both sexes. Inverse associations were observed for women regarding hemorrhagic stroke.
Area of Science:
- Cardiovascular Epidemiology
- Lipid Metabolism
- Neurology
Background:
- The relationship between cholesterol levels, specifically total and high-density lipoprotein (HDL) cholesterol, and the risk of stroke, particularly hemorrhagic stroke, requires further clarification.
- Existing research presents conflicting findings regarding the impact of cholesterol on different stroke subtypes.
Purpose of the Study:
- To prospectively examine the associations between serum total cholesterol, HDL cholesterol, and the total/HDL cholesterol ratio with the incidence of total and type-specific strokes.
- To investigate potential sex-specific differences in these associations.
Main Methods:
- A prospective study involving 58,235 Finnish individuals aged 25-74 years, initially free from coronary heart disease and stroke.
- Longitudinal follow-up for a mean of 20.1 years to record stroke events, including ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage.
- Multivariable regression analyses were employed to assess hazard ratios, with adjustments for various risk factors.
Main Results:
- Elevated total cholesterol was associated with increased risk of total and ischemic stroke in men, but inversely associated with intracerebral hemorrhagic stroke risk in women.
- Low HDL cholesterol and high total/HDL cholesterol ratio were linked to higher risks of total and ischemic stroke in both sexes.
- These lipid-associated stroke risks attenuated after adjusting for body mass index, blood pressure, and diabetes, with some associations remaining significant in women.
Conclusions:
- Total cholesterol exhibits a sex-specific association with stroke risk: positive for total and ischemic stroke in men, inverse for hemorrhagic stroke in women.
- HDL cholesterol and the total/HDL ratio demonstrate associations with stroke risk, though these are influenced by other cardiovascular risk factors.
- The findings highlight the complex interplay between lipid profiles, sex, and stroke etiology, underscoring the need for nuanced risk assessment.
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