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Total and high-density lipoprotein cholesterol and stroke risk.

Abstract

BACKGROUND AND PURPOSE

The association of total and high-density lipoprotein (HDL) cholesterol with stroke risk is unclear, especially regarding hemorrhagic stroke.

METHODS

We prospectively investigated the associations of serum total and HDL cholesterol and total/HDL cholesterol ratio with total and type-specific stroke incidence among 58,235 Finnish people aged 25 to 74 years and free of coronary heart disease and stroke at baseline.

RESULTS

During a mean follow-up period of 20.1 years, 3914 participants developed stroke events (3085 ischemic, 497 intracerebral hemorrhage, and 332 subarachnoid hemorrhage). The multivariable-adjusted hazard ratios at different levels of total cholesterol (<5 [reference], 5-5.9, 6-6.0, ≥7.0 mmol/L) were 1.00, 1.05, 1.16, and 1.22 for total stroke (Ptrend=0.036) and 1.00, 1.06, 1.19, and 1.27 for ischemic stroke (Ptrend=0.02) in men and 1.00, 0.58, 0.61, and 0.50 for intracerebral hemorrhagic stroke (Ptrend=0.02) in women, respectively. Low levels of HDL cholesterol and high total/HDL cholesterol ratio were associated with increased risks of total and ischemic stroke in both men and women. These associations disappeared in men but remained significant in women after further adjustment for body mass index, blood pressure, and history of diabetes.

CONCLUSIONS

The study showed a positive association between total cholesterol and total and ischemic stroke risks in men and an inverse association between total cholesterol and intrahemorrhagic stroke risk in women. The inverse association of HDL cholesterol and a positive association of total/HDL cholesterol ratio with total and ischemic stroke risks were found in men and women. These associations attenuated after adjustment for body mass index, blood pressure, and history of diabetes.

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  • Authors+Show Affiliations

    ,

    First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi, China. zhangyurong72@163.com

    , , , ,

    Source

    Stroke 43:7 2012 Jul pg 1768-74

    MeSH

    Adult
    Aged
    Cholesterol
    Cholesterol, HDL
    Cohort Studies
    Female
    Finland
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Prospective Studies
    Risk Factors
    Stroke
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22496337

    Citation

    Zhang, Yurong, et al. "Total and High-density Lipoprotein Cholesterol and Stroke Risk." Stroke, vol. 43, no. 7, 2012, pp. 1768-74.
    Zhang Y, Tuomilehto J, Jousilahti P, et al. Total and high-density lipoprotein cholesterol and stroke risk. Stroke. 2012;43(7):1768-74.
    Zhang, Y., Tuomilehto, J., Jousilahti, P., Wang, Y., Antikainen, R., & Hu, G. (2012). Total and high-density lipoprotein cholesterol and stroke risk. Stroke, 43(7), pp. 1768-74. doi:10.1161/STROKEAHA.111.646778.
    Zhang Y, et al. Total and High-density Lipoprotein Cholesterol and Stroke Risk. Stroke. 2012;43(7):1768-74. PubMed PMID: 22496337.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Total and high-density lipoprotein cholesterol and stroke risk. AU - Zhang,Yurong, AU - Tuomilehto,Jaakko, AU - Jousilahti,Pekka, AU - Wang,Yujie, AU - Antikainen,Riitta, AU - Hu,Gang, Y1 - 2012/04/10/ PY - 2012/4/13/entrez PY - 2012/4/13/pubmed PY - 2012/9/5/medline SP - 1768 EP - 74 JF - Stroke JO - Stroke VL - 43 IS - 7 N2 - BACKGROUND AND PURPOSE: The association of total and high-density lipoprotein (HDL) cholesterol with stroke risk is unclear, especially regarding hemorrhagic stroke. METHODS: We prospectively investigated the associations of serum total and HDL cholesterol and total/HDL cholesterol ratio with total and type-specific stroke incidence among 58,235 Finnish people aged 25 to 74 years and free of coronary heart disease and stroke at baseline. RESULTS: During a mean follow-up period of 20.1 years, 3914 participants developed stroke events (3085 ischemic, 497 intracerebral hemorrhage, and 332 subarachnoid hemorrhage). The multivariable-adjusted hazard ratios at different levels of total cholesterol (<5 [reference], 5-5.9, 6-6.0, ≥7.0 mmol/L) were 1.00, 1.05, 1.16, and 1.22 for total stroke (Ptrend=0.036) and 1.00, 1.06, 1.19, and 1.27 for ischemic stroke (Ptrend=0.02) in men and 1.00, 0.58, 0.61, and 0.50 for intracerebral hemorrhagic stroke (Ptrend=0.02) in women, respectively. Low levels of HDL cholesterol and high total/HDL cholesterol ratio were associated with increased risks of total and ischemic stroke in both men and women. These associations disappeared in men but remained significant in women after further adjustment for body mass index, blood pressure, and history of diabetes. CONCLUSIONS: The study showed a positive association between total cholesterol and total and ischemic stroke risks in men and an inverse association between total cholesterol and intrahemorrhagic stroke risk in women. The inverse association of HDL cholesterol and a positive association of total/HDL cholesterol ratio with total and ischemic stroke risks were found in men and women. These associations attenuated after adjustment for body mass index, blood pressure, and history of diabetes. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/22496337/Total_and_high_density_lipoprotein_cholesterol_and_stroke_risk_ L2 - http://www.ahajournals.org/doi/full/10.1161/STROKEAHA.111.646778?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -