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Cholesterol and the Risk of Ischemic Stroke
Open accessAbstract
Background and Purpose— Large epidemiological studies have not established cholesterol levels as a risk factor for ischemic stroke, but recent clinical trials have demonstrated a reduction in the ischemic stroke rate for patients taking HMG-CoA reductase inhibitors (“statins”). The goal of this study was to evaluate whether total cholesterol (TC), high-density lipoprotein (HDL), triglycerides, and the TC:HDL ratio are risk factors for ischemic stroke in apparently healthy men enrolled in the Physicians’ Health Study. Methods— We used a nested case-control study design and matched 296 ischemic stroke cases with an equal number of controls on age, tobacco use, and follow-up time. At baseline, TC, HDL, and triglyceride levels were measured. We calculated odds ratios (ORs) and their 95% confidence intervals (CIs) using conditional logistic regression, adjusting for major risk factors for ischemic stroke. Results— Compared with the reference lowest quartile, the highest quartile for TC had an adjusted OR of 1.56 (95% CI, 0.84 to 2.92), the highest quartile of HDL had an adjusted OR of 0.75 (95% CI, 0.43 to 1.30), and the highest quartile of triglycerides had an adjusted OR of 1.07 (95% CI, 0.63 to 1.82). Although the highest quartile of the TC:HDL ratio had an adjusted OR of 1.62 (95% CI, 0.93 to 2.82), the risk of ischemic stroke was not a linear relationship. Conclusions— After adjustment, TC, HDL, and triglycerides were not significantly associated with ischemic stroke risk, and for the TC:HDL ratio, a suggestion of increased risk of ischemic stroke was limited to those with the highest levels.
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“There have been many reports, including those from Japan, stating that the lower the HDL-C level, the higher the incidence rate of cerebral infarction46, 859–861).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [859]
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Cites
OLSSON, A. G., McMurray, J. J. V., Thorgeirsson, G., Spaulding, C. M., Slattery, J., Pyörälà, K., Færgeman, O., Wright, R. S., Berg, K. M., Wilhelmsen, L., et al. (1994) · The Lancet · Cited by 8,467
Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia
Shepherd, J., Cobbe, S. M., Ford, I., Isles, C. G., Lorimer, A. R., Macfarlane, P. W., McKillop, J. H., & Packard, C. J. (1995) · New England Journal of Medicine · doi:10.1056/nejm199511163332001 · Cited by 7,449
Sacks, F. M., Pfeffer, M. A., Moye, L. A., Rouleau, J. L., Rutherford, J. D., Cole, T. G., Brown, L., Warnica, J. W., Arnold, J. M. O., Wun, C.-C., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610033351401 · Cited by 7,439
(1998) · New England Journal of Medicine · doi:10.1056/nejm199811053391902 · Cited by 5,261
Downs, J. R., Clearfield, M., Weis, S., Whitney, E., Shapiro, D. R., Beere, P. A., Langendorfer, A., Stein, E. A., Kruyer, W., Gotto, Jr., et al. (1998) · JAMA · doi:10.1001/jama.279.20.1615 · Cited by 5,236
Hennekens, C. H., Buring, J. E., Manson, J. E., Stampfer, M., Rosner, B., Cook, N. R., Belanger, C., LaMotte, F., Gaziano, J. M., Ridker, P. M., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199605023341801 · Cited by 2,397
Self-citationFinal Report on the Aspirin Component of the Ongoing Physicians' Health Study
Steering Committee of the Physicians' Health Study Research Group (1989) · New England Journal of Medicine · doi:10.1056/nejm198907203210301 · Cited by 2,267
Tuomilehto, J., Vidgrén, G., Toivanen, L., Tuomilehto‐Wolf, E., Kohtamäki, K., Stengård, J., Zimmet, P., Mackay, I. R., Rowley, M. J., & Koskela, P. U. (1994) · The Lancet · doi:10.1016/s0140-6736(94)92521-6 · Cited by 1,691
A prospective study of cholesterol, apolipoproteins, and the risk of myocardial infarction.
Stampfer, M. J., Sacks, F. M., Salvini, S., Willett, W. C., & Hennekens, C. H. (1991) · New England Journal of Medicine · doi:10.1056/nejm199108083250601 · Cited by 1,163
Self-citationIso, H., Jacobs, D. R., Wentworth, D. N., Neaton, J. D., & Cohen, J. D. (1989) · New England Journal of Medicine · doi:10.1056/nejm198904063201405 · Cited by 1,130
Stampfer, M. J. (1996) · JAMA · doi:10.1001/jama.1996.03540110036029 · Cited by 1,081
Self-citationAntiatherothrombotic Properties of Statins
Rosenson, R. S., & Tangney, C. (1998) · JAMA · doi:10.1001/jama.279.20.1643 · Cited by 954
Primary Prevention of Ischemic Stroke
Goldstein, L. B., Adams, R. J., Becker, K. J., Furberg, C. D., Gorelick, P. B., Hádemenos, G. J., Hill, M., Howard, G., Howard, V. J., Jacobs, B. S., et al. (2001) · Stroke · doi:10.1161/01.str.32.1.280 · Cited by 902
Prospective Studies Collaboration, & Kromhout, D. (1995) · The Lancet · doi:10.1016/s0140-6736(95)92836-7 · Cited by 851
Hebert, P. R. (1997) · JAMA · doi:10.1001/jama.1997.03550040069040 · Cited by 740
Body mass index and the risk of stroke in men
Kurth, T., Gaziano, J. M., Berger, K., Kase, C. S., Rexrode, K. M., Cook, N. R., Buring, J. E., & Manson, J. E. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.22.2557 · Cited by 524
Self-citationCholesterol and Coronary Heart Disease: Predicting Risks by Levels and Ratios
Kinosian, B., Glick, H., & Garland, G. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-121-9-199411010-00002 · Cited by 519
Pedersen, T. R., KJEKSHUS, J. K., Pyörälà, K., OLSSON, A. G., Cook, T. J., Musliner, T. A., Tobert, J. A., & Haghfelt, T. H. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00904-1 · Cited by 465
The National Survey of Stroke. Clinical findings.
Walker, A., Robins, M., & Weinfeld, F. D. (1981) · PubMed · Cited by 460
Pravastatin Therapy and the Risk of Stroke
White, H. D., Simes, R. J., Anderson, N. E., Hankey, G. J., Watson, J. D. G., Hunt, D., Colquhoun, D. M., Glasziou, P., MacMahon, S. W., Kirby, A. C., et al. (2000) · New England Journal of Medicine · doi:10.1056/nejm200008033430502 · Cited by 335
Shahar, E., Chambless, L. E., Rosamond, W. D., Boland, L. L., Ballantyne, C. M., McGovern, P. G., & Sharrett, A. R. (2003) · Stroke · doi:10.1161/01.str.0000057812.51734.ff · Cited by 325
Sacco, R. L., Benson, R. T., Kargman, D. E., Boden-Albala, B., Tuck, C., Lin, I.-F., Cheng, J. F., Paik, M. C., Shea, S., & Berglund, L. (2001) · JAMA · doi:10.1001/jama.285.21.2729 · Cited by 311
Reduction of Stroke Events With Pravastatin
Byington, R. P., Davis, B. R., Plehn, J. F., White, H. D., Baker, J., Cobbe, S. M., & Shepherd, J. (2001) · Circulation · doi:10.1161/01.cir.103.3.387 · Cited by 275
Leppälä, J. M., Virtamo, J., Fogelholm, R., Albanes, D., & Heinonen, O. P. (1999) · Stroke · doi:10.1161/01.str.30.12.2535 · Cited by 272
Reduction in Stroke With Gemfibrozil in Men With Coronary Heart Disease and Low HDL Cholesterol
Bloomfield, H. E., Davenport, J., Babikian, V. L., Brass, L. M., Collins, D. E., WEXLER, L. F., Wagner, S., Papademetriou, V., Rutan, G. H., & Robins, S. J. (2001) · Circulation · doi:10.1161/01.cir.103.23.2828 · Cited by 265
Effect of HMGcoA Reductase Inhibitors on Stroke
Bucher, H. C., Griffith, L. E., & Guyatt, G. H. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-128-2-199801150-00002 · Cited by 229
HDL-Cholesterol, Total Cholesterol, and the Risk of Stroke in Middle-Aged British Men
Wannamethee, S. G., Shaper, A. G., & Ebrahim, S. (2000) · Stroke · doi:10.1161/01.str.31.8.1882 · Cited by 220
Current Status of Risk Factors for Stroke
Wolf, P. A., Kannel, W. B., & Verter, J. I. (1983) · Neurologic Clinics · doi:10.1016/s0733-8619(18)31185-x · Cited by 187
Epidemiologic aspects of lipid abnormalities
Criqui, M. H., & Golomb, B. A. (1998) · The American Journal of Medicine · doi:10.1016/s0002-9343(98)00212-5 · Cited by 158
An Overview of Trials of Cholesterol Lowering and Risk of Stroke
Hebert, P. R. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430010054007 · Cited by 116
Hart, C., Hole, D. J., & Smith, G. D. (2000) · Stroke · doi:10.1161/01.str.31.8.1893 · Cited by 95
Koren‐Morag, N. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.9.993 · Cited by 88
Interobserver Agreement in the Classification of Stroke in the Women’s Health Study
Atiya, M., Kurth, T., Berger, K., Buring, J. E., & Kase, C. S. (2003) · Stroke · doi:10.1161/01.str.0000054159.21017.7c · Cited by 81
Self-citationInterobserver Agreement in the Classification of Stroke in the Physicians’ Health Study
Berger, K., Kase, C. S., & Buring, J. E. (1996) · Stroke · doi:10.1161/01.str.27.2.238 · Cited by 68
Self-citationManson, J. E., Buring, J. E., Satterfield, S., & Hennekens, C. H. (1991) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)30931-0 · Cited by 49
Is Cholesterol a Risk Factor for Stroke?
Demchuk, A. M., Hess, D. C., Brass, L. M., & Yatsu, F. M. (1999) · Archives of Neurology · doi:10.1001/archneur.56.12.1518 · Cited by 48
Callahan, A. S. (2001) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)01882-3 · Cited by 31
Statins for Stroke: The Second Story?
Plutzky, J., & Ridker, P. M. (2001) · Circulation · doi:10.1161/01.cir.103.3.348 · Cited by 24
Taylor, W. C., & Landau, W. M. (1990) · Annals of Neurology · doi:10.1002/ana.410280122 · Cited by 21
Are risk factors for stroke and coronary disease the same?
Qizilbash, N. (1998) · Current Opinion in Lipidology · doi:10.1097/00041433-199808000-00007 · Cited by 15
Reduction of stroke events with pravastatin. The Prospective Pravastatin Pooling (PPP) Project.
Barrellier, M. ‐. (2008) · Cited by 14
Cholesterol lowering and the vessel wall: new insights and future perspectives
Štulc, T., & Češka, R. (2001) · Physiological Research · doi:10.33549/physiolres.930081 · Cited by 10
Skin biopsy is useful for diagnosis of infantile neuroaxonal dystrophy
PhD, C. C., & Martin, J. (1990) · Annals of Neurology · doi:10.1002/ana.410280124 · Cited by 4
Research works printed but not linked: 8
- 10.1161/str.32.1.280 · DOI
- NCEP. Summary of third report of NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults III. JAMA. 2001: 2486–2497.
- 10.1161/str.27.2.238 · DOI
- 10.1161/str.30.12.2535 · DOI
- 10.1161/str.31.8.1893 · DOI
- 10.1161/str.31.8.1882 · DOI
- 10.1161/circ.103.3.348 · DOI
- 10.1161/circ.103.23.2828 · DOI
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Self-citation
Metadata
- Authors
- Bowman, T. S., Sesso, H. D., Ma, J., Kurth, T., Kase, C. S., Stampfer, M. J., & Gaziano, J. M.
- Affiliations
- Boston University (US)
- Venue
- Stroke
- Published
- 2003-12
- Volume
- 34
- Issue
- 12
- Pages
- 2930-2934
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2080056609
- Cited by
- 157
- References
- 45
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 10 · 2021: 7 · 2020: 5 · 2019: 9 · 2018: 10 · 2017: 5 · 2016: 8 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 7
- FWCI
- 7.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (CA 34944, HL-26490)
- National Heart, Lung, and Blood Institute (HL-34595, HL 26490, R01HL034595)
- National Cancer Institute (R01CA040360, CA 34944, R01CA097193, CA 40360)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- ischemic stroke, total cholesterol, high-density lipoprotein, triglycerides, TC/HDL-C ratio, stroke risk factors, statins, Physicians' Health Study, healthy men
- MeSH terms
- Brain Ischemia, Cholesterol, Humans, Lipoproteins, HDL, Male, Middle Aged, Prospective Studies, Risk, Risk Factors, Triglycerides, United States, Comorbidity, Logistic Models, Odds Ratio, Case-Control Studies, Randomized Controlled Trials as Topic, Stroke
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