RT Journal Article
SR Electronic
T1 Lipid levels and the risk of hemorrhagic stroke among women
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e2286
OP e2294
DO 10.1212/WNL.0000000000007454
VO 92
IS 19
A1 Rist, Pamela M.
A1 Buring, Julie E.
A1 Ridker, Paul M
A1 Kase, Carlos S.
A1 Kurth, Tobias
A1 Rexrode, Kathryn M.
YR 2019
UL http://n.neurology.org/content/92/19/e2286.abstract
AB Objective To examine the association between lipid levels and hemorrhagic stroke risk among women.Methods We performed a prospective cohort study among 27,937 women enrolled in the Women's Health Study with measured total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), as well as triglycerides. Strokes were confirmed by medical record review. We used Cox proportional hazards models to analyze associations between lipid categories and hemorrhagic stroke risk.Results During a mean of 19.3 years of follow-up, 137 hemorrhagic strokes occurred. Compared to those with LDL-C levels 100–129.9 mg/dL, after multivariable adjustment, those with LDL-C levels <70 mg/dL had 2.17 times the risk (95% confidence interval [CI] 1.05, 4.48) of experiencing a hemorrhagic stroke. No significant increase in risk was seen for those with LDL-C levels 130–159.9 mg/dL (relative risk [RR] 1.14; 95% CI 0.72, 1.80) or 70–99.9 mg/dL (RR 1.25; 95% CI 0.76, 2.04). There was a suggestion, although not significant, of increased risk for those with LDL-C levels ≥160 mg/dL (RR 1.53; 95% CI 0.92, 2.52). Women in the lowest quartile of triglycerides had a significantly increased risk of hemorrhagic stroke compared to women in the top quartile after multivariable adjustment (RR 2.00; 95% CI 1.18, 3.39). We observed no significant associations between total cholesterol or HDL-C levels and hemorrhagic stroke risk.Conclusion LDL-C levels <70 mg/dL and low triglyceride levels were associated with increased risk of hemorrhagic stroke among women.CI=confidence interval; HDL-C=high-density lipoprotein cholesterol; ICH=intracerebral hemorrhage; IVH=intraventricular hemorrhage; LDL-C=low-density lipoprotein cholesterol; PMH=postmenopausal hormone; RR=relative risk; SAH=subarachnoid hemorrhage; WHS=Women's Health Study