High-Density Lipoprotein Cholesterol and the Risk of First Ischemic Stroke in a Chinese Hypertensive Population.

Abstract

BACKGROUND AND PURPOSE:

Elevated high-density lipoprotein cholesterol (HDL-C) levels have displayed protection against cardiovascular disease. However, the association between specific lipoprotein classes and first ischemic stroke (IS) has not been well defined, particularly in higher-risk hypertensive populations. Our study evaluated the associations of HDL-C with first IS in a Chinese hypertensive population.

METHODS:

The study population was obtained from a community-based cohort study of hypertension in Lianyungang and Rongcheng, China. A nested case-control design was used that included 2463 identified first IS cases and 2463 controls matched by age ± 1 year, sex, and region.

RESULTS:

After adjusting for potential confounders, HDL-C was inversely associated with first IS (adjusted odds ratio [aOR]: 0.91; 95% confidence interval [CI]: 0.85-0.98). HDL-C levels of at least 65.4 mg/dL displayed a significant protective effect for first IS (aOR: 0.82; 95% CI: 0.69-0.98). Conversely, adverse effects of first IS were observed for low-density lipoprotein cholesterol (LDL-C) levels ≥138.1 mg/dL (aOR: 1.20; 95% CI: 1.02-1.42) and triglyceride (TG) levels ≥140.8 mg/dL (aOR: 1.27; 95% CI: 1.09-1.49). The risk associations of LDL-C and TG with first IS were attenuated in the presence of high HDL-C (≥53.0 mg/dL); an increased risk of first IS was only found in the presence of low HDL-C (<53.0 mg/dL) when LDL-C (aOR: 1.66; 95% CI: 1.19-2.31) and TG (aOR: 1.47; 95% CI: 1.17-1.84) were combined with HDL-C for analysis.

CONCLUSION:

In this community-based Chinese hypertensive population, higher HDL-C was a significant protective factor of first IS. These data add to the evidence describing the relationship between lipids and IS and suggest that HDL-C maybe is a marker of IS risk in Chinses hypertensive population.

• Authors: Yue Zhang, Jingyi Li, Chengzhang Liu, Hongxiang Yu, Chen Chen, Chonglei Bi, Chongqian Fang, Hai Ma, Aimin Li, Qing Dong, Lishun Liu, Binyan Wang, Xiao Huang, Xiaoshu Cheng, Pierre Zalloua, Xiping Xu, Yong Huo, Gang Li
• Journal: Clinical interventions in aging (Clin Interv Aging) Vol. 16 Pg. 801-810 ( 2021) ISSN: 1178-1998 [Electronic] New Zealand
• PMID: 34017170 (Publication Type: Journal Article)
• Copyright: © 2021 Zhang et al.

Chemical References

• Biomarkers
• Cholesterol, HDL
• Lipids

Topics

• Aged
• Biomarkers
• Case-Control Studies
• China (epidemiology)
• Cholesterol, HDL (blood)
• Female
• Humans
• Hypertension (epidemiology, physiopathology)
• Ischemic Stroke (epidemiology, physiopathology)
• Lipids (blood)
• Male
• Middle Aged
• Odds Ratio
• Risk Factors