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Area of Science:

  • Cardiovascular Science
  • Neurology
  • Lipid Metabolism

Background:

  • Small dense low-density lipoprotein (sdLDL) cholesterol is suspected to be atherogenic.
  • High sdLDL cholesterol is linked to ischemic heart disease risk.
  • The association between sdLDL cholesterol and ischemic stroke risk in the general population remains under-explored.

Purpose of the Study:

  • To investigate the association between small dense low-density lipoprotein cholesterol levels and the risk of ischemic stroke.
  • To test the hypothesis that elevated sdLDL cholesterol is a risk factor for ischemic stroke.

Main Methods:

  • Prospective study of 38,319 individuals from the Copenhagen General Population Study.
  • Fresh sample measurements of sdLDL cholesterol.
  • Median follow-up of 3.1 years, observing 302 ischemic and 74 hemorrhagic strokes.

Main Results:

  • Higher sdLDL cholesterol levels showed a log-linear association with increased ischemic stroke risk.
  • Individuals in the highest tertile of sdLDL cholesterol had a 1.79-fold increased risk of ischemic stroke compared to the lowest tertile.
  • A 1 mmol/l increase in sdLDL cholesterol was associated with a 1.69-fold increased risk of ischemic stroke, independent of other LDL subtypes.

Conclusions:

  • Elevated levels of small dense low-density lipoprotein cholesterol are robustly associated with a higher risk of ischemic stroke.
  • sdLDL cholesterol emerges as a significant and independent risk factor for ischemic stroke.
  • These findings have implications for stroke risk assessment and prevention strategies.