title: Lipid profiles and ischemic stroke risk: variations by sex within racial/ethnic groups.
abstract: Evidence implicates lipid abnormalities as important but modifiable risk factors for stroke. This study assesses whether hypercholesterolemia can be used to predict the risk for etiologic subtypes of ischemic stroke between sexes within racial/ethnic groups. Data elements related to stroke risk, diagnosis, and outcomes were abstracted from the medical records of 3,290 acute stroke admissions between 2006 and 2010 at a regional stroke center. Sex comparison within racial/ethnic groups revealed that South Asian and Hispanic men had a higher proportion of ischemic stroke than women, while the inverse was true for Whites and African Americans (P=0.0014). All women, except South Asian women, had higher mean plasma total cholesterol and higher blood circulating low-density lipoprotein levels (≥100 mg/dL) than men at the time of their admissions. The incidence of large-artery atherosclerosis (LAA) was more common among women than men, except among Hispanics, where men tended to have higher incidences. A regression analysis that considered patients diagnosed with either LAA or small-artery occlusion etiologic subtype as the outcomes and high-density lipoproteins and triglycerides as predictors showed inconsistent associations between lipid profiles and the incidence of these subtypes between the sexes within racial/ethnic groups. In conclusion, our investigation suggests that women stroke patients may be at increased risk for stroke etiologic subtype LAA than men. Although the higher prevalence of stroke risk factors examined in this study predicts the increase in the incidence of the disease, lack of knowledge/awareness and lack of affordable treatments for stroke risk factors among women and immigrants/non-US-born subpopulations may explain the observed associations.
authors.affiliation: Edward J. Bloustein School of Planning and Public Policy, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.
authors.forename: Tefera
authors.initials: T
authors.lastname: Gezmu
authors.affiliation: Edward J. Bloustein School of Planning and Public Policy, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.
authors.forename: Dona
authors.initials: D
authors.lastname: Schneider
authors.affiliation: Rutgers School of Public Health, Department of Epidemiology, Piscataway, NJ, USA.
authors.forename: Kitaw
authors.initials: K
authors.lastname: Demissie
authors.affiliation: Rutgers School of Public Health, Department of Epidemiology, Piscataway, NJ, USA.
authors.forename: Yong
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Giordano
authors.affiliation: New Jersey Neuroscience Institute at JFK Medical Center and Seton Hall University, Edison, NJ, USA.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Gizzi
keywords: cerebrovascular disease; comorbidities; ischemic stroke; race/ethnicity; risk factors; sex