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Stroke remains a major factor in morbidity and mortality worldwide, especially in East Asian countries
.
In many previous epidemiological studies, HDL-C (high-density lipoprotein cholesterol) has been shown to be inversely related to total stroke and ischemic stroke
However, most previous epidemiological studies have been conducted in populations of European and African ancestry, and data are relatively sparse in populations of Asian ancestry, in which hemorrhagic stroke accounts for a larger proportion of the cerebrovascular disease burden
.
In particular, a previous pooled analysis in Asian adults found that higher HDL cholesterol was not associated with a lower risk of ischemic and hemorrhagic stroke
Furthermore, the relationship between HDL-C and stroke risk may not be linear, and previous studies have been relatively underpowered to assess the nonlinear relationship
.
Furthermore, most previous studies were based on a single baseline HDL-C measurement, which may have underestimated the association between HDL-C and stroke risk due to physiological and longitudinal changes in HDL-C concentrations
They included 96 258 people (79.
6% male, mean age 51.
After adjusting for cardiovascular risk factors, those with cumulative mean HDL-C ≤1.
06 mmol/L or ≥2.
05 mmol/L had a hazard ratio of 1.
31 ( 95% CI, 1.
15-1.
49) and 1.
85 (1.
63-2.
09)
.
The corresponding hazard ratios were 1.
29 (1.
11-1.
48) and 1.
84 (1.
60-2.
11) for ischemic stroke and 1.
54 (1.
12-2.
12) and 2.
29 (1.
73-3.
04) for hemorrhagic stroke
.
The significance of this study is its finding that both low and high cumulative mean HDL-C were associated with increased risk of ischemic and hemorrhagic stroke
.
.
Original source:
Li H, Qian F, Zuo Y, et al.
U-Shaped Relationship of High-Density Lipoprotein Cholesterol and Incidence of Total, Ischemic and Hemorrhagic Stroke: A Prospective Cohort Study.
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