Cholesterol predicts stroke mortality in the Women's Pooling Project.
OBJECTIVE
Cholesterol is emerging as a risk factor for stroke; however, few data are available regarding the relation of cholesterol and stroke mortality in women and ethnic minorities.


METHODS
We evaluated the risk of death caused by total stroke, nonhemorrhagic stroke, and hemorrhagic stroke by race, age, and cholesterol quintile in 24 343 women with no previous cardiovascular disease who were participating in 8 US longitudinal, prospective, cohort studies included in the Women's Pooling Project.


RESULTS
We observed 568 stroke deaths (461 nonhemorrhagic, 83 hemorrhagic) for women > or =30 years of age without previous cardiovascular disease during 339 215 person-years of follow-up. In multivariate models, black women <55 years of age had a 76% increased risk of death caused by stroke compared with white women [relative risk (RR), 1.76; 95% confidence interval (CI), 1.10 to 2.81]. For black women <55 years of age, the top compared with the lowest cholesterol quintile (Q5 versus Q1) remained an independent predictor of stroke mortality (RR, 2.58; 95% CI, 1.05 to 6.32) in multivariate models. For white women <55 years of age, Q5 versus Q1 cholesterol did not predict stroke mortality with significance (RR, 1.47; 95% CI, 0.57 to 3.76). In analogous multivariate models, we found a positive relation between continuous cholesterol and nonhemorrhagic stroke death in women <55 years of age (RR, 1.23; 95% CI, 1.02 to 1.49).


CONCLUSIONS
Our results show that cholesterol is a risk factor for nonhemorrhagic stroke death in women <55 years of age and is more strongly associated with mortality in black women <55 years of age than in white women. These data document the importance of cholesterol in addition to established risk factors for predicting stroke mortality in young women and may guide prevention strategies.
Horenstein
Richard B
RB
Department of Medicine, University of Maryland Medical System, Baltimore, USA.
Smith
Dean E
DE
Mosca
Lori
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000401:mortality*; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000401:mortality*; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American
D002784:Cholesterol