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Relation between blood lipids, lipoproteins, and cerebrovascular atherosclerosis. A review
G S Tell1, J R Crouse, C D Furberg
1Center for Prevention Research and Biometry, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
Insights
Blood lipids and lipoproteins are linked to cerebrovascular atherosclerosis, especially in older adults. Further research with standardized methods is needed to clarify this relationship.
Area of Science:
- Neuroscience
- Cardiovascular Science
- Biochemistry
Background:
- Blood lipids and lipoproteins are established risk factors for coronary atherosclerosis.
- The association between lipids, lipoproteins, and cerebrovascular atherosclerosis is less understood.
- Existing research presents varied findings, hindering clear conclusions.
Purpose of the Study:
- To review and synthesize existing literature on the relationship between plasma lipid and lipoprotein concentrations and cerebrovascular atherosclerosis.
- To identify the strength and nature of this association across different populations and methodologies.
Main Methods:
- A comprehensive review of over 20 publications was conducted.
- Studies investigating the link between plasma lipid/lipoprotein levels and cerebrovascular atherosclerosis were analyzed.
- Methodological variations across studies were noted as a limitation.
Main Results:
- A relationship between blood lipids/lipoproteins and cerebrovascular atherosclerosis was found in most (23 out of 26) reviewed studies.
- The association appears stronger in older individuals compared to younger ones.
- Specific details of the relationship are obscured by significant inter-study variations in methodology.
Conclusions:
- A link between blood lipids, lipoproteins, and cerebrovascular atherosclerosis is generally supported by current evidence.
- The strength of the association increases with age.
- Standardized methodologies are crucial for future research to elucidate this relationship definitively.
Abstract:
Although blood lipids and lipoproteins are strongly related to coronary atherosclerosis, their association with cerebrovascular atherosclerosis is less clear. A review of more than 20 publications in which a relation was sought between plasma lipid and lipoprotein concentrations and cerebrovascular atherosclerosis leads to the general conclusion that such a relation exists and that it is stronger in older than in younger individuals. A relation was found between blood lipids and/or lipoproteins and the extent and/or severity of cerebrovascular atherosclerosis in all but three of 26 reviewed studies. However, the specific nature of the relation is obscure because the various studies cannot easily be compared with one another. Interstudy variations in lipoprotein fraction analyzed, methodology for the analysis of lipids and lipoproteins, arterial segment examined, population sampled, control selection in case-control studies, statistical analytic approach taken, and methodology for the assessment of arterial disease preclude pooled analyses. There is a clear need for further evaluation of this relation using standardized and up-to-date methodologies both for analyses of lipids and lipoproteins and for assessment of cerebrovascular disease in symptom-free volunteers as well as in symptomatic patients.
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