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High LDL does’t confer increased risk of stroke

High LDL does’t confer increased risk of stroke
Familial hypercholesterolemia(FH) is a condition with very high concentrations of low-density lipoprotein(LDL) cholesterol and high risk of ischemic heart disease including myocardial infarction.Dr.Sabina Beheshti at Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark, and colleagues conducted a Copenhagen General Population study to explore the Relationship of Familial Hypercholesterolemia and High LDL Cholesterol to Ischemic Stroke both in terms of prevalence and cause.They have found that FH and high LDL cholesterol did not confer an increased risk of ischemic stroke.The study has been published in Circulation.
The investigators tested associations of FH and high LDL cholesterol with ischemic stroke risk in both causal, genetic and observational analyses using 106,412 individuals from the Copenhagen General Population Study and/or 10,372 individuals from the Copenhagen City Heart Study(CCHS; 945 ischemic strokes and 1,142 myocardial infarctions).  They adopted a Mendelian randomization design for the study using a combination of the FH causative mutations and common genetic variants associated with high LDL cholesterol.

The researchers found that cumulative incidences in individuals in the CGPS with and without FH causative mutations were similar for ischemic stroke but not for myocardial infarction at age 80. They found that there was no association between clinical FH and ischemic stroke, except if personal premature ischemic heart disease was included in the clinical FH criteria. Ischemic heart disease at baseline was associated with higher ischemic stroke risk, explaining its higher risk in those with high LDL cholesterol. For a 1mmol/L higher LDL cholesterol the genetic causal risk ratio was 1.11(0.62-2.02) for ischemic stroke and 1.45(1.08-1.93) for myocardial infarction.

The authors Concluded that FH and high LDL cholesterol did not confer an increased risk of ischemic stroke. A positive association with it observed for some clinical FH criteria and high LDL cholesterol appears to be due to previous ischemic heart disease, rather than by high LDL cholesterol per se.

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