BACKGROUND AND PURPOSE: Accurate identification of risk factors for stroke is important for public health promotion and disease prevention. HDL cholesterol is a potential risk factor, yet its role in stroke risk is unclear, as is whether HDL cholesterol content or particle number might be a better indicator of stroke risk. Furthermore, the degree to which ethnicity moderates the risk is unknown. As such, the current study examines the associations between incident stroke and both HDL cholesterol concentration and particle number, and assesses the moderating role of race and ethnicity. METHODS: The sample is a racially diverse cohort of US adults between the ages of 45-84 years enrolled in the Multi-Ethnic Study of Atherosclerosis between 2000 and 2002 and followed until December 2011. The associations among cholesterol content and stroke risk, particle number and stroke risk, and the interaction with race were explored. RESULTS: The incidence of stroke was 2.6%. HDL cholesterol concentration (mmol/L) (Hazard Ratio (HR) = .56; 95% Confidence Interval (CI): .312-.988) and number of large HDL particles (μmol/L) (HR = .52, CI: .278-.956) were associated with lower stroke risk. When interactions with race were evaluated, the relationship between both HDL variables and stroke were significant in Blacks, but not other races. CONCLUSIONS: Higher HDL cholesterol and a higher concentration of large particles are associated with lower risk of stroke in Blacks. Further research is needed to elucidate the mechanisms by which HDL subfractions may differentially affect stroke outcome in different races/ethnicities.
BACKGROUND AND PURPOSE: Accurate identification of risk factors for stroke is important for public health promotion and disease prevention. HDL cholesterol is a potential risk factor, yet its role in stroke risk is unclear, as is whether HDL cholesterol content or particle number might be a better indicator of stroke risk. Furthermore, the degree to which ethnicity moderates the risk is unknown. As such, the current study examines the associations between incident stroke and both HDL cholesterol concentration and particle number, and assesses the moderating role of race and ethnicity. METHODS: The sample is a racially diverse cohort of US adults between the ages of 45-84 years enrolled in the Multi-Ethnic Study of Atherosclerosis between 2000 and 2002 and followed until December 2011. The associations among cholesterol content and stroke risk, particle number and stroke risk, and the interaction with race were explored. RESULTS: The incidence of stroke was 2.6%. HDL cholesterol concentration (mmol/L) (Hazard Ratio (HR) = .56; 95% Confidence Interval (CI): .312-.988) and number of large HDL particles (μmol/L) (HR = .52, CI: .278-.956) were associated with lower stroke risk. When interactions with race were evaluated, the relationship between both HDL variables and stroke were significant in Blacks, but not other races. CONCLUSIONS: Higher HDL cholesterol and a higher concentration of large particles are associated with lower risk of stroke in Blacks. Further research is needed to elucidate the mechanisms by which HDL subfractions may differentially affect stroke outcome in different races/ethnicities.
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: Yun Shen; Lizheng Shi; Elizabeth Nauman; Peter T Katzmarzyk; Eboni G Price-Haywood; Alessandra N Bazzano; Somesh Nigam; Gang Hu Journal: Stroke Date: 2019-02 Impact factor: 7.914
Authors: Michelle Averill; Katya B Rubinow; Kevin Cain; Jake Wimberger; Ilona Babenko; Jessica O Becker; Karen E Foster-Schubert; David E Cummings; Andrew N Hoofnagle; Tomas Vaisar Journal: J Clin Lipidol Date: 2019-11-22 Impact factor: 4.766
Authors: Deanna L Plubell; Alex M Fenton; Sara Rosario; Paige Bergstrom; Phillip A Wilmarth; Wayne M Clark; Neil A Zakai; Joseph F Quinn; Jessica Minnier; Nabil J Alkayed; Sergio Fazio; Nathalie Pamir Journal: Circ Res Date: 2020-08-26 Impact factor: 17.367
Authors: Leoné Malan; Mark Hamer; Roland von Känel; Konstantin Kotliar; Roelof D van Wyk; Gavin W Lambert; Walthard Vilser; Tjalf Ziemssen; Markus P Schlaich; Wayne Smith; Martin Magnusson; Annemarie Wentzel; Carlien E Myburgh; Hendrik S Steyn; Nico T Malan Journal: Cardiovasc J Afr Date: 2020-10-26 Impact factor: 1.167