title: Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myocardial infarction: Korean national health system prospective cohort study.
abstract: OBJECTIVE
  To investigate risk factors, such as heavy alcohol consumption, that might explain any increased risk of haemorrhagic stroke associated with low blood cholesterol.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Korea.
  
  
  METHODS
  787,442 civil servants (661,700 men, 125,742 women) aged 30-64.
  
  
  METHODS
  Cardiovascular risk factors were assessed at biennial health check. Data on morbidity and mortality were ascertained from 1990 to 2001 using hospital admissions and mortality surveillance systems.
  
  
  RESULTS
  6328 cases of ischaemic stroke (6021 men, 307 women), 3947 cases of haemorrhagic stroke (3748 men, 199 women), 3170 cases of undefined stroke (2902 men, 268 women), and 4417 cases of myocardial infarction (4305 men, 112 women) occurred. Ischaemic stroke and myocardial infarction were strongly and positively associated with blood cholesterol (hazard ratio per 1 mmol/l cholesterol 1.20 (95% confidence 1.16 to 1.24) and 1.48 (1.43 to 1.53), respectively). Haemorrhagic stroke showed an inverse association in fully adjusted models (0.91, 0.87 to 0.95). This inverse association was confined to participants with hypertension. When stratified by concentration of gamma glutamyl transferase (GGT), an indicator of alcohol consumption, the association was not seen in participants with low concentrations of GGT, and it was independent of hypertension in those with high concentrations of GGT (> 80 U/l).
authors.affiliation: Department of Social Medicine, University of Bristol, Bristol BS8 2PR.
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.forename: Joohon
authors.initials: J
authors.lastname: Sung
authors.forename: Yun-Mi
authors.initials: YM
authors.lastname: Song
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferrer
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.forename: George
authors.initials: G
authors.lastname: Davey Smith
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000401:mortality; D002784:Cholesterol / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000401:mortality; D020521:Stroke / Q000097:blood / Q000209:etiology* / Q000401:mortality; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D002784:Cholesterol; D005723:gamma-Glutamyltransferase