Am J Epidemiol 2004; 160:150-157.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
High Density Lipoprotein Cholesterol and the Risk of Stroke in Elderly Men
The Honolulu Heart Program
1 Pacific Health Research Institute, Honolulu, HI.
2 Departments of Geriatric Medicine and Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
3 Honolulu Heart Program, Kuakini Medical Center, Honolulu, HI.
4 Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VA.
High density lipoprotein (HDL) cholesterol has been inversely associated with coronary heart disease. Associations with stroke are less clear, particularly among the elderly. In this study, the authors examined the relation between HDL cholesterol levels and the risk of stroke in elderly men. Levels of HDL cholesterol were measured in 2,444 Honolulu Heart Program men aged 71–93 years at the 1991–1993 examinations. The participants, who were free of prevalent stroke, coronary heart disease, and cancer at baseline, were followed to the end of 1998 for thromboembolic and hemorrhagic stroke. While HDL cholesterol was unrelated to hemorrhagic events, incidence of thromboembolic stroke declined consistently with increasing HDL cholesterol level (p = 0.003). There was a nearly threefold excess of thromboembolic stroke in men with low HDL cholesterol levels (<1.0 mmol/liter (<40 mg/dl)) compared with men with high levels (
1.6 mmol/liter (60 mg/dl)) (10.6/1,000 person-years vs. 3.6/1,000 person-years; p = 0.001). Adjustment for other risk factors had little effect on these findings, although associations appeared strongest in elderly men with "desirable" total cholesterol levels, hypertension, or diabetes mellitus. These findings suggest that HDL cholesterol level is inversely related to the risk of thromboembolic stroke in elderly men. Whether HDL cholesterol alters the effect of other factors on stroke risk in elderly men warrants further study.
aged; cerebrovascular accident; lipoproteins, HDL cholesterol; men
Abbreviations: Abbreviation: HDL, high density lipoprotein.
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