title: What is the association of lipid levels and incident stroke?
abstract: BACKGROUND
  The association between lipid levels and stroke rates is less than lipid levels and coronary heart disease (CHD).
  
  
  OBJECTIVE
  To assess if there are geographic, racial, and ethnic differences in total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride levels with incident stroke.
  
  
  METHODS
  From the REasons for Geographic And Racial Differences in Stroke (REGARDS) study we evaluated baseline levels of LDL-C, HCL-C, TC, Non-HDL-C (Total-HDL-C) and triglycerides in participants free of prevalent stroke at baseline. Cox Proportional-Hazard models were the main analytical tool used to examine the association between incident stroke and lipids. For each adjusted lipid measure (LDL-C, HDL-C, triglycerides, TC, and non-HDL-C) we calculated a series of incremental models.
  
  
  RESULTS
  The analysis cohort was 23,867 participants with a mean follow-up time of 7.5±2.9years, and 1031 centrally adjudicated strokes (874 ischemic and 77 hemorrhagic strokes). HDL-C baseline level was associated with an overall unadjusted 13% risk reduction (HR 0.87, 95% confidence interval [CI]: 0.81-0.93; p<0.05; 14% for ischemic and 16% for hemorrhagic strokes), and TC with an 8% (HR 0.92, 95%CI: 0.87-0.99; p<0.05) risk reduction of all strokes. When the results were fully adjusted a significant association was observed only for LDL-C and non-HDL-C and ischemic stroke. There were no significant differences in these associations when adjusted for age, race, age∗race, gender, education, region, or income.
  
  
  CONCLUSIONS
  In a disease free population, LDL-C and non-HDL-C baseline levels are significantly associated with the risk of ischemic stroke.
authors.affiliation: Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: sglasser@uabmc.edu.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Glasser
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: amosher@uab.edu.
authors.forename: Aleena
authors.initials: A
authors.lastname: Mosher
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: ghoward@uab.edu.
authors.forename: George
authors.initials: G
authors.lastname: Howard
authors.affiliation: Department of Hypertension, Medical University of Lodz, Lodz, Poland. Electronic address: maciejbanach@aol.co.uk.
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D014280:Triglycerides / Q000097:blood*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Cholesterol; Hemorrhagic; Ischemic; Lipids; Stroke