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Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage: A prospective study

Chaoran Ma1, M Edip Gurol1, Zhe Huang1

  • 1From the Department of Nutritional Sciences (C.M.), Eberly College of Science (S.N.), and Department of Nutritional Sciences (X.G.), Pennsylvania State University, University Park; Hemorrhagic Stroke Research Program (M.E.G.), Massachusetts General Hospital and Harvard Medical School, Boston; Departments of Cardiology (Z.H., S.W.) and Neurology (X.W., Y.W.), Kailuan General Hospital, Tangshan, China; and Jean Mayer USDA Human Nutrition Research Center on Aging (A.H.L.), Tufts University, Boston, MA.

Neurology
|July 4, 2019
PubMed

Insights

Lowering low-density lipoprotein cholesterol (LDL-C) below 70 mg/dL significantly increases intracerebral hemorrhage (ICH) risk. Maintaining LDL-C levels at or above 70 mg/dL appears safer for preventing ICH.

Area of Science:

  • Neurology
  • Cardiology
  • Epidemiology

Background:

  • Intracerebral hemorrhage (ICH) is a severe type of stroke.
  • Low-density lipoprotein cholesterol (LDL-C) is a known risk factor for atherosclerotic diseases.
  • The relationship between LDL-C levels and ICH risk is not fully understood.

Purpose of the Study:

  • To prospectively investigate the association between serum LDL-C concentrations and the risk of developing intracerebral hemorrhage.
  • To identify potential target LDL-C ranges for individuals at risk of both atherosclerotic and hemorrhagic stroke.

Main Methods:

  • A cohort study of 96,043 participants free of major cardiovascular events and cancer at baseline.
  • Serum LDL-C levels were measured multiple times between 2006 and 2012.
  • Cumulative average LDL-C was calculated, and incident ICH cases were tracked over 9 years.

Main Results:

  • A total of 753 incident ICH cases were identified.
  • ICH risk was similar for LDL-C levels of 70-99 mg/dL and ≥100 mg/dL.
  • Significantly higher ICH risk was observed for LDL-C <70 mg/dL (HR 1.65 for 50-69 mg/dL, HR 2.69 for <50 mg/dL).

Conclusions:

  • Lower LDL-C concentrations (<70 mg/dL) are associated with an increased risk of ICH.
  • The association between LDL-C and ICH risk becomes nonsignificant at levels ≥70 mg/dL.
  • These findings suggest an optimal LDL-C range for patients at risk of both atherosclerotic and hemorrhagic stroke.
Abstract

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