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Published on: October 12, 2017

Association of HDL-C Levels with Stroke and All-cause Mortality: A Prospective Cohort Study from the CHARLS

Zhi Liu1,2,3, Libo Liang4, Xiao Du5

  • 1Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, P. R. China.

Brain and Behavior
|March 10, 2026
PubMed

Insights

High-density lipoprotein cholesterol (HDL-C) protects against stroke in Chinese adults over 45. Body Mass Index (BMI) partially mediates this effect, but HDL-C does not impact overall mortality.

Area of Science:

  • Cardiovascular Epidemiology
  • Public Health Research
  • Gerontology

Background:

  • Stroke poses a significant health challenge in China.
  • Re-evaluation of the high-density lipoprotein cholesterol (HDL-C) and stroke relationship is warranted.
  • Large-scale population studies are crucial for understanding cardiovascular risk factors.

Purpose of the Study:

  • To investigate the association between HDL-C and stroke risk in middle-aged and elderly Chinese individuals.
  • To examine the relationship between HDL-C and all-cause mortality in the same population.
  • To explore the mediating role of Body Mass Index (BMI) in the HDL-C-stroke association.

Main Methods:

  • Utilized data from the China Health and Retirement Longitudinal Study (CHARLS).
  • Employed logistic and Cox regression analyses, including time-varying and competing-risk models.
  • Performed subgroup, sensitivity, and mediation analyses for robust interpretation.

Main Results:

  • HDL-C demonstrated a protective effect against stroke, particularly in males, normal BMI individuals, those without dyslipidemia, and hypertensive patients.
  • No significant association was found between HDL-C and all-cause mortality.
  • Body Mass Index (BMI) was identified as a mediator, accounting for 25% of HDL-C's effect on stroke risk.

Conclusions:

  • HDL-C serves as a protective factor for stroke in Chinese adults aged 45 and above.
  • HDL-C levels were not significantly associated with all-cause mortality in this cohort.
  • Findings underscore the importance of HDL-C in stroke risk stratification and management.
Abstract

Keywords:
HDL‐Cmortalityriskstroke

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