Pamela M Rist1, Julie E Buring2, Paul M Ridker2, Carlos S Kase2, Tobias Kurth2, Kathryn M Rexrode2. 1. From the Division of Preventive Medicine, Department of Medicine (P.M. Rist, J.E.B., P.M Ridker), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Neurology (C.S.K.), Emory University, Atlanta, GA; Institute of Public Health (T.K.), Charité-Universitätsmedizin, Berlin, Germany; and Division of Women's Health, Department of Medicine (K.M.R.), Brigham and Women's Hospital, Boston, MA. prist@mail.harvard.edu. 2. From the Division of Preventive Medicine, Department of Medicine (P.M. Rist, J.E.B., P.M Ridker), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Neurology (C.S.K.), Emory University, Atlanta, GA; Institute of Public Health (T.K.), Charité-Universitätsmedizin, Berlin, Germany; and Division of Women's Health, Department of Medicine (K.M.R.), Brigham and Women's Hospital, Boston, MA.
Abstract
OBJECTIVE: To examine the association between lipid levels and hemorrhagic stroke risk among women. METHODS: We performed a prospective cohort study among 27,937 women enrolled in the Women's Health Study with measured total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), as well as triglycerides. Strokes were confirmed by medical record review. We used Cox proportional hazards models to analyze associations between lipid categories and hemorrhagic stroke risk. RESULTS: During a mean of 19.3 years of follow-up, 137 hemorrhagic strokes occurred. Compared to those with LDL-C levels 100-129.9 mg/dL, after multivariable adjustment, those with LDL-C levels <70 mg/dL had 2.17 times the risk (95% confidence interval [CI] 1.05, 4.48) of experiencing a hemorrhagic stroke. No significant increase in risk was seen for those with LDL-C levels 130-159.9 mg/dL (relative risk [RR] 1.14; 95% CI 0.72, 1.80) or 70-99.9 mg/dL (RR 1.25; 95% CI 0.76, 2.04). There was a suggestion, although not significant, of increased risk for those with LDL-C levels ≥160 mg/dL (RR 1.53; 95% CI 0.92, 2.52). Women in the lowest quartile of triglycerides had a significantly increased risk of hemorrhagic stroke compared to women in the top quartile after multivariable adjustment (RR 2.00; 95% CI 1.18, 3.39). We observed no significant associations between total cholesterol or HDL-C levels and hemorrhagic stroke risk. CONCLUSION: LDL-C levels <70 mg/dL and low triglyceride levels were associated with increased risk of hemorrhagic stroke among women.
OBJECTIVE: To examine the association between lipid levels and hemorrhagic stroke risk among women. METHODS: We performed a prospective cohort study among 27,937 women enrolled in the Women's Health Study with measured total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), as well as triglycerides. Strokes were confirmed by medical record review. We used Cox proportional hazards models to analyze associations between lipid categories and hemorrhagic stroke risk. RESULTS: During a mean of 19.3 years of follow-up, 137 hemorrhagic strokes occurred. Compared to those with LDL-C levels 100-129.9 mg/dL, after multivariable adjustment, those with LDL-C levels <70 mg/dL had 2.17 times the risk (95% confidence interval [CI] 1.05, 4.48) of experiencing a hemorrhagic stroke. No significant increase in risk was seen for those with LDL-C levels 130-159.9 mg/dL (relative risk [RR] 1.14; 95% CI 0.72, 1.80) or 70-99.9 mg/dL (RR 1.25; 95% CI 0.76, 2.04). There was a suggestion, although not significant, of increased risk for those with LDL-C levels ≥160 mg/dL (RR 1.53; 95% CI 0.92, 2.52). Women in the lowest quartile of triglycerides had a significantly increased risk of hemorrhagic stroke compared to women in the top quartile after multivariable adjustment (RR 2.00; 95% CI 1.18, 3.39). We observed no significant associations between total cholesterol or HDL-C levels and hemorrhagic stroke risk. CONCLUSION: LDL-C levels <70 mg/dL and low triglyceride levels were associated with increased risk of hemorrhagic stroke among women.
Authors: Elisabet Zia; Hélène Pessah-Rasmussen; Farhad Ali Khan; Bo Norrving; Lars Janzon; Goran Berglund; Gunnar Engstrom Journal: Cerebrovasc Dis Date: 2005-11-08 Impact factor: 2.762
Authors: James F Meschia; Cheryl Bushnell; Bernadette Boden-Albala; Lynne T Braun; Dawn M Bravata; Seemant Chaturvedi; Mark A Creager; Robert H Eckel; Mitchell S V Elkind; Myriam Fornage; Larry B Goldstein; Steven M Greenberg; Susanna E Horvath; Costantino Iadecola; Edward C Jauch; Wesley S Moore; John A Wilson Journal: Stroke Date: 2014-10-28 Impact factor: 7.914
Authors: Yurong Zhang; Jaakko Tuomilehto; Pekka Jousilahti; Yujie Wang; Riitta Antikainen; Gang Hu Journal: Stroke Date: 2012-04-10 Impact factor: 7.914
Authors: Paul M Ridker; Nancy R Cook; I-Min Lee; David Gordon; J Michael Gaziano; Joann E Manson; Charles H Hennekens; Julie E Buring Journal: N Engl J Med Date: 2005-03-07 Impact factor: 91.245
Authors: B Mihaylova; J Emberson; L Blackwell; A Keech; J Simes; E H Barnes; M Voysey; A Gray; R Collins; C Baigent Journal: Lancet Date: 2012-05-17 Impact factor: 79.321
Authors: José R Romero; Sarah R Preis; Alexa Beiser; Charles DeCarli; Ralph B D'Agostino; Philip A Wolf; Ramachandran S Vasan; Joseph F Polak; Sudha Seshadri Journal: J Am Heart Assoc Date: 2016-03-18 Impact factor: 5.501
Authors: Kathryn M Rexrode; Tracy E Madsen; Amy Y X Yu; Cheryl Carcel; Judith H Lichtman; Eliza C Miller Journal: Circ Res Date: 2022-02-17 Impact factor: 17.367
Authors: J Wouter Jukema; Laurien E Zijlstra; Deepak L Bhatt; Vera A Bittner; Rafael Diaz; Heinz Drexel; Shaun G Goodman; Yong-Un Kim; Robert Pordy; Željko Reiner; Matthew T Roe; Hung-Fat Tse; Pablo Carlos Montenegro Valdovinos; Harvey D White; Andreas M Zeiher; Michael Szarek; Gregory G Schwartz; Philippe Gabriel Steg Journal: Circulation Date: 2019-11-11 Impact factor: 29.690
Authors: Zien Zhou; Meg J Jardine; Qiang Li; Brendon L Neuen; Christopher P Cannon; Dick de Zeeuw; Robert Edwards; Adeera Levin; Kenneth W Mahaffey; Vlado Perkovic; Bruce Neal; Richard I Lindley Journal: Stroke Date: 2021-04-20 Impact factor: 7.914
Authors: Jennifer R Meeks; Arvind B Bambhroliya; Katie M Alex; Sunil A Sheth; Sean I Savitz; Eliza C Miller; Louise D McCullough; Farhaan S Vahidy Journal: JAMA Netw Open Date: 2020-04-01