Serum Total Cholesterol and Fatal Subarachnoid Hemorrhage in 120,000 Japanese: A Pooled Analysis of Data from 12...

Area of Science:

• Cardiovascular Epidemiology
• Cerebrovascular Disease Research
• Biomarker Analysis

Background:

• Subarachnoid hemorrhage (SAH) is a critical cause of cerebrovascular mortality.
• Serum total cholesterol is a well-established cardiovascular risk factor, but its association with fatal SAH requires further clarification, particularly across different populations and sexes.

Purpose of the Study:

• To investigate the relationship between serum total cholesterol levels and the risk of fatal subarachnoid hemorrhage among Japanese men and women.
• To determine if this association differs between sexes.

Main Methods:

• Pooled analysis of individual data from 12 Japanese cohort studies, including 120,973 participants.
• Participants categorized into six serum total cholesterol groups.
• Follow-up for a median of 12.7 years, with fatal SAH as the primary outcome.

Main Results:

• A total of 261 deaths from SAH were recorded.
• In women, both low (<5.69 mmol/L) and high (≥6.21 mmol/L) serum total cholesterol levels were significantly associated with increased fatal SAH risk compared to the reference group (5.69-6.20 mmol/L).
• These associations in women persisted after adjusting for confounding factors, but no significant associations were found in men.

Conclusions:

• Serum total cholesterol exhibits a U-shaped association with fatal subarachnoid hemorrhage risk in Japanese women.
• The findings suggest sex-specific differences in the impact of cholesterol levels on SAH mortality.
• Further research may explore the underlying biological mechanisms for these observed sex differences.