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What is the association of lipid levels and incident stroke?
Stephen P Glasser1, Aleena Mosher2, George Howard2
1Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Insights
Baseline levels of LDL-C and non-HDL-C are linked to increased ischemic stroke risk. These lipid levels are significant predictors of stroke in individuals without prior disease.
Area of Science:
- Cardiovascular Epidemiology
- Neuroscience
- Biochemistry
Background:
- The relationship between lipid profiles and stroke incidence is less understood compared to coronary heart disease.
- Investigating lipid levels' impact on stroke risk is crucial for public health.
Purpose of the Study:
- To determine if geographic, racial, and ethnic factors influence total cholesterol (TC), LDL-C, HDL-C, and triglyceride levels in relation to incident stroke.
- To analyze the association between baseline lipid levels and the risk of developing stroke across diverse populations.
Main Methods:
- Utilized data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
- Evaluated baseline lipid levels (LDL-C, HDL-C, TC, non-HDL-C, triglycerides) in participants without prevalent stroke.
- Employed Cox Proportional-Hazard models to assess the association between lipid measures and incident stroke, with incremental adjustments.
Main Results:
- The cohort included 23,867 participants with a mean follow-up of 7.5 years, documenting 1031 strokes.
- Unadjusted analysis showed HDL-C and TC were associated with reduced stroke risk.
- Fully adjusted models revealed significant associations between LDL-C, non-HDL-C, and ischemic stroke risk, with no significant demographic or geographic variations.
Conclusions:
- Baseline LDL-C and non-HDL-C levels are significantly associated with the risk of ischemic stroke in a disease-free population.
- These findings highlight the importance of monitoring specific lipid parameters for stroke risk assessment.
Background:
The association between lipid levels and stroke rates is less than lipid levels and coronary heart disease (CHD).
Objective:
To assess if there are geographic, racial, and ethnic differences in total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride levels with incident stroke.
Methods:
From the REasons for Geographic And Racial Differences in Stroke (REGARDS) study we evaluated baseline levels of LDL-C, HCL-C, TC, Non-HDL-C (Total-HDL-C) and triglycerides in participants free of prevalent stroke at baseline. Cox Proportional-Hazard models were the main analytical tool used to examine the association between incident stroke and lipids. For each adjusted lipid measure (LDL-C, HDL-C, triglycerides, TC, and non-HDL-C) we calculated a series of incremental models.
Results:
The analysis cohort was 23,867 participants with a mean follow-up time of 7.5±2.9years, and 1031 centrally adjudicated strokes (874 ischemic and 77 hemorrhagic strokes). HDL-C baseline level was associated with an overall unadjusted 13% risk reduction (HR 0.87, 95% confidence interval [CI]: 0.81-0.93; p<0.05; 14% for ischemic and 16% for hemorrhagic strokes), and TC with an 8% (HR 0.92, 95%CI: 0.87-0.99; p<0.05) risk reduction of all strokes. When the results were fully adjusted a significant association was observed only for LDL-C and non-HDL-C and ischemic stroke. There were no significant differences in these associations when adjusted for age, race, age∗race, gender, education, region, or income.
Conclusion:
In a disease free population, LDL-C and non-HDL-C baseline levels are significantly associated with the risk of ischemic stroke.
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