Relationship Between High-density Lipoprotein (HDL) Cholesterol with Ischaemic Stroke

Background: Ischemic stroke, a major cause of disability and death, is strongly influenced by modifiable risk factors such as dyslipidemia. High-density lipoprotein (HDL) cholesterol, known for its protective vascular roles, has been inversely associated with stroke risk and severity. However, data on this relationship in the Bangladeshi population remain limited. Aim: This study aimed to determine the Relationship between High-density lipoprotein (HDL) cholesterol with Ischaemic stroke. Methods: This cross-sectional study was conducted at Mymensingh Medical College Hospital, Mymensingh, Bangladesh, from January 1, 2012, to December 31, 2012. 100 adult patients with clinically and radiologically confirmed ischemic stroke who were admitted to the hospital during the study period. Data were analyzed using SPSS v26, with p < 0.05 considered significant. Results: The mean age of patients was 64.8 ± 9.6 years, with 62% being male. Low HDL was observed in 72% of patients. A significant inverse relationship was found between HDL levels and stroke severity (p < 0.001), with lower HDL associated with more severe strokes. HDL also differed significantly across ischemic stroke subtypes (p = 0.03), being lowest in large artery atherosclerosis and cardioembolic strokes. Low HDL was significantly associated with hypertension (p = 0.04) and showed inverse correlations with LDL (r = -0.29), triglycerides (r = -0.35), total cholesterol (r = -0.23), CRP (r = -0.31), and NIHSS score (r = -0.43). Logistic regression revealed that low HDL (OR = 3.82, p = 0.001), hypertension (OR = 2.76, p = 0.016), and high LDL (OR = 2.14, p = 0.036) were significant predictors of severe stroke. While favorable outcomes were more common in patients with normal HDL, the difference was not statistically significant (p = 0.24). Conclusion: Low HDL cholesterol is prevalent among ischemic stroke patients and is significantly associated with greater stroke severity, certain stroke subtypes, and inflammatory and lipid markers. These findings suggest that HDL may serve as a useful biomarker for assessing stroke risk and severity.