Takeaway
- Women with a low-density lipoprotein cholesterol (LDL-C) level of <70 mg/dL had a more than doubling of hemorrhagic stroke risk relative to counterparts with normal levels.
Why this matters
- Lipid-lowering strategies are a mainstay in cardiovascular disease prevention.
Key results
- 137 hemorrhagic strokes during mean 19.3-year follow-up.
- In multivariate analysis with women having LDL-C 100-129.9 mg/dL as comparator, relative risk (95% CI) for hemorrhagic stroke:
- LDL-C <70 mg/dL (2.17; 1.05-4.48);
- LDL-C 70-99.9 mg/dL (1.25; 0.76-2.04);
- LDL-C 130-159.9 mg/dL (1.14; 0.72-1.80); and
- LDL-C ≥160 mg/dL (1.53; 0.92-2.52).
- Elevation of risk for those in lowest category seen for intracerebral hemorrhage and subarachnoid hemorrhage individually.
- Women in lowest quartile of triglycerides (≤74 mg/dL) had increased hemorrhagic stroke risk vs peers in top quartile (>156 mg/dL; relative risk, 2.00; 95% CI, 1.18-3.39).
- Neither total cholesterol nor high-density lipoprotein cholesterol levels significantly associated with hemorrhagic stroke risk.
Study design
- Prospective cohort study among 27,937 women in Women’s Health Study with lipid measurement at baseline.
- Main outcome: hemorrhagic stroke confirmed by medical record review.
- Funding: NIH.
Limitations
- Largely white, postmenopausal population with low level of statin use.
- Limited power for stroke subtype analyses.
- Single lipid measurement at baseline.
- Potential residual confounding.
References
References