Key result
Low HDL-C (<30 mg/dL) was associated with a significantly increased risk of all stroke incidence compared to high HDL-C (≥60 mg/dL) (RR 2.89; 95% CI 1.35-6.20).
Why the study?
Does low HDL-C increase the risk of all stroke and ischemic stroke in Japanese men and women?
Cohort (n=4,989)
Does low HDL-C increase the risk of all stroke and ischemic stroke in Japanese men and women?
Effect estimate: RR 2.89 (95% CI 1.35 to 6.20)
Lower HDL-C levels are significantly and independently associated with an increased risk of all stroke and ischemic stroke in Japanese men and women.
Low HDL-C may mark higher stroke risk in Japanese adults; hypothesis-generating, prospective trials needed before practice change.
BACKGROUND AND PURPOSE: Evidence of an inverse relationship between serum high-density lipoprotein cholesterol (HDL-C) and the risk of stroke is sparse in Asians and in women. The purpose of this investigation was to examine the relationship in a long-term cohort study of Japanese men and women among whom stroke occurrence is higher than in Western countries. METHODS: A prospective cohort study was performed involving 4989 participants (1523 men, 3466 women) 35 to 79 years of age at baseline with approximately 10 years of follow-up in a rural area of Japan. End points included all stroke incidence and ischemic stroke incidence. RESULTS: During follow-up, 132 participants developed stroke, including 81 ischemic stroke cases. Age-adjusted incidence rates per 10,000 person-years for all stroke in subjects with low HDL-C (<30 mg/dL [0.78 mmol/L]) were 103.4 in men and 49.3 in women, which were remarkably higher than in subjects with high HDL-C (>or=60 mg/dL [1.56 mmol/L]) (26.4 in men and 15.5 in women). A similar relationship was observed for ischemic stroke. Multivariate-adjusted relative risks for all stroke incidence and ischemic stroke incidence were 2.89 (95% CI, 1.35 to 6.20) and 2.92 (95% CI, 1.17 to 7.32), respectively, for low versus high HDL-C participants. The relationships were independent of sex, age, body mass index, blood pressure, serum total cholesterol, alcohol consumption, and smoking. CONCLUSIONS: This 10-year follow-up study of Japanese men and women demonstrated that lower HDL-C levels were related significantly and independently to increased risk of all stroke incidence and ischemic stroke incidence.
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Soyama et al. (2003) conducted a cohort in Stroke risk (n=4,989). Low HDL-C (<30 mg/dL) vs. High HDL-C (≥60 mg/dL) was evaluated on All stroke incidence (RR 2.89, 95% CI 1.35 to 6.20). Low HDL-C (<30 mg/dL) was associated with a significantly increased risk of all stroke incidence compared to high HDL-C (≥60 mg/dL) (RR 2.89; 95% CI 1.35-6.20).
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