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Influence of total cholesterol, high density lipoprotein cholesterol, and triglycerides on risk of cerebrovascular disease: the Copenhagen city heart study

Department of Neurology, 433, Hvidovre Hospital,20Kettegards Alle 30, 2650 Hvidovre, Denmark20Copenhagen City Heart Study, Rigshospitalet, 2200 Copenhagen N Correspondecne to: Dr Lindenstrom.

Abstract

Objective : To estimate the influence of plasma total cholesterol, high density lipoprotein cholesterol, and triglycerides on risk of cerebrovascular disease.
Design : The Copenhagen city heart study is a prospective observational survey with two cardiovascular examinations at five year intervals. Non- fasting plasma lipids were measured in participants once at each examination, along with other variables. The Cox regression model was used to establish the effect of the factors recorded on cerebrovascular events of mostly, but not exclusively, ischaemic origin. Subjects - 19 698 women and men at least 20 years old, randomly selected after age stratification from an area of central Copenhagen.
Main outcome measures : Initial cases of stroke and transient ischaemic attack recorded from hospital records and death certificates from 1976 through 1988.
Results : 660 non-haemorrhagic and 33 haemorrhagic events were recorded. Total cholesterol was positively associated with risk of non-haemorrhagic events, but only for levels >8 mmol/l, correspaonding to the upper 5% of the distribution in the study population. For lower plasma cholesterol values the relative risk remained nearly constant. Plasma triglyceride concentration was significantly, positively associated with risk of non- haemorrhagic events. The relative risk corresponding to an increase of 1 mmol/l was 1.12 (95% confidence interval 1.07 to 1.16). There was a negative, log linear association between high density lipoprotein cholesterol and risk of non-haemorrhagic events (0.53 (0.34 to 0.83)). There was no indication that the20effects of plasma lipids were different in women and men.
Conclusions : The pattern of the association between plasma cholesterol and risk of ischaemic cerebrovascular disease was not log linear, and the increased risk was confined to the upper 5% of the cholesterol distribution. Further studies should concentrate on the association between plasma cholesterol and varified haemorrhagic stroke.

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• Milionis, H. J., Rizos, E., Goudevenos, J., Seferiadis, K., Mikhailidis, D. P., Elisaf, M. S. (2005). Components of the Metabolic Syndrome and Risk for First-Ever Acute Ischemic Nonembolic Stroke in Elderly Subjects. Stroke 36: 1372-1376 [Abstract] [Full text]  
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• Tirschwell, D. L., Smith, N. L., Heckbert, S. R., Lemaitre, R. N., Longstreth, W. T. Jr., Psaty, B. M. (2004). Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups. Neurology 63: 1868-1875 [Abstract] [Full text]  
• Asia Pacific Cohort Studies Collaboration, (2004). Serum Triglycerides as a Risk Factor for Cardiovascular Diseases in the Asia-Pacific Region. Circulation 110: 2678-2686 [Abstract] [Full text]  
• Amarenco, P., Tonkin, A. M. (2004). Statins for Stroke Prevention: Disappointment and Hope. Circulation 109: III-44-III-49 [Abstract] [Full text]  
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• Piechowski-Jozwiak, B., Bogousslavsky, J. (2004). Cholesterol as a Risk Factor for Stroke: The Fugitive?. Stroke 35: 1523-1524 [Full text]  
• Asia Pacific Cohort Studies Collaboration, (2003). Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol 32: 563-572 [Abstract] [Full text]  
• Soyama, Y., Miura, K., Morikawa, Y., Nishijo, M., Nakanishi, Y., Naruse, Y., Kagamimori, S., Nakagawa, H. (2003). High-Density Lipoprotein Cholesterol and Risk of Stroke in Japanese Men and Women: The Oyabe Study. Stroke 34: 863-868 [Abstract] [Full text]  
• Corvol, J.-C., Bouzamondo, A., Sirol, M., Hulot, J.-S., Sanchez, P., Lechat, P. (2003). Differential Effects of Lipid-Lowering Therapies on Stroke Prevention: A Meta-analysis of Randomized Trials. Arch Intern Med 163: 669-676 [Abstract] [Full text]  
• Shahar, E., Chambless, L. E., Rosamond, W. D., Boland, L. L., Ballantyne, C. M., McGovern, P. G., Sharrett, A. R. (2003). Plasma Lipid Profile and Incident Ischemic Stroke: The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 34: 623-631 [Abstract] [Full text]  
• Lee, S.-H., Bae, H.-J., Yoon, B.-W., Kim, H., Kim, D.-E., Roh, J.-K. (2002). Low Concentration of Serum Total Cholesterol Is Associated With Multifocal Signal Loss Lesions on Gradient-Echo Magnetic Resonance Imaging: Analysis of Risk Factors for Multifocal Signal Loss Lesions. Stroke 33: 2845-2849 [Abstract] [Full text]  
• Engstrom, G., Lind, P., Hedblad, B., Stavenow, L., Janzon, L., Lindgarde, F. (2002). Effects of Cholesterol and Inflammation-Sensitive Plasma Proteins on Incidence of Myocardial Infarction and Stroke in Men. Circulation 105: 2632-2637 [Abstract] [Full text]  
• Koren-Morag, N., Tanne, D., Graff, E., Goldbourt, U., for the Bezafibrate Infarction Prevention Study Gr, (2002). Low- and High-Density Lipoprotein Cholesterol and Ischemic Cerebrovascular Disease: The Bezafibrate Infarction Prevention Registry. Arch Intern Med 162: 993-999 [Abstract] [Full text]  
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• Tanne, D., Koren-Morag, N., Graff, E., Goldbourt, U. (2001). Blood Lipids and First-Ever Ischemic Stroke/Transient Ischemic Attack in the Bezafibrate Infarction Prevention (BIP) Registry: High Triglycerides Constitute an Independent Risk Factor. Circulation 104: 2892-2897 [Abstract] [Full text]  
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• Frikke-Schmidt, R., Nordestgaard, B.G., Thudium, D., Moes Gronholdt, M.-L., Tybjarg-Hansen, A. (2001). APOE genotype predicts AD and other dementia but not ischemic cerebrovascular disease. Neurology 56: 194-200 [Abstract] [Full text]  
• Goldstein, L. B., Adams, R., Becker, K., Furberg, C. D., Gorelick, P. B., Hademenos, G., Hill, M., Howard, G., Howard, V. J., Jacobs, B., Levine, S. R., Mosca, L., Sacco, R. L., Sherman, D. G., Wolf, P. A., del Zoppo, G. J., Members, (2001). Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association. Circulation 103: 163-182 [Full text]  
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• Wannamethee, S. G., Shaper, A. G., Ebrahim, S. (2000). HDL-Cholesterol, Total Cholesterol, and the Risk of Stroke in Middle-Aged British Men. Stroke 31: 1882-1888 [Abstract] [Full text]  
• Albucher, J F, Ferrieres, J, Ruidavets, J B, Guiraud-Chaumeil, B, Perret, B P, Chollet, F (2000). Serum lipids in young patients with ischaemic stroke: a case-control study. J. Neurol. Neurosurg. Psychiatry 69: 29-33 [Abstract] [Full text]  
• Milionis, H. J, Winder, A. F, Mikhailidis, D. P (2000). Lipoprotein (a) and stroke. J. Clin. Pathol. 53: 487-496 [Abstract] [Full text]  
• Leppala, J. M., Virtamo, J., Fogelholm, R., Albanes, D., Heinonen, O. P. (1999). Different Risk Factors for Different Stroke Subtypes : Association of Blood Pressure, Cholesterol, and Antioxidants. Stroke 30: 2535-2540 [Abstract] [Full text]  
• Dreyer, L., Olsen, J. H. (1999). Risk for Non-smoking-related Cancer in Atherosclerotic Patients. Cancer Epidemiol. Biomarkers Prev. 8: 915-918 [Abstract] [Full text]  
• Leppala, J. M., Paunio, M., Virtamo, J., Fogelholm, R., Albanes, D., Taylor, P. R., Heinonen, O. P. (1999). Alcohol Consumption and Stroke Incidence in Male Smokers. Circulation 100: 1209-1214 [Abstract] [Full text]  
• Plehn, J. F., Davis, B. R., Sacks, F. M., Rouleau, J. L., Pfeffer, M. A., Bernstein, V., Cuddy, T. E., Moye, L. A., Piller, L. B., Rutherford, J., Simpson, L. M., Braunwald, E. (1999). Reduction of Stroke Incidence After Myocardial Infarction With Pravastatin : The Cholesterol and Recurrent Events (CARE) Study. Circulation 99: 216-223 [Abstract] [Full text]  
• Gronholdt, M.-L. M. (1999). Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery. Arterioscler. Thromb. Vasc. Bio. 19: 2-13 [Abstract] [Full text]  
• Papadakis, J. A, Mikhailidis, D. P, Winder, A. F (1998). Lipids and stroke: neglect of a useful preventive measure?. Cardiovasc Res 40: 265-271 [Abstract] [Full text]  
• Pringle, M., Jones, J. (1998). Preventing ischaemic heart disease in one general practice: from one patient, through clinical audit, needs assessment, and commissioning into quality improvement • Commentary: Clinical and economic perspectives have to be integrated when selecting priorities for intervention. BMJ 317: 1120-1124 [Full text]  
• Bisgaier, C. L., Essenburg, A. D., Barnett, B. C., Auerbach, B. J., Haubenwallner, S., Leff, T., White, A. D., Creger, P., Pape, M. E., Rea, T. J., Newton, R. S. (1998). A novel compound that elevates high density lipoprotein and activates the peroxisome proliferator activated receptor. J. Lipid Res. 39: 17-30 [Abstract] [Full text]  
• Al-Shoumer, K. A. S., Cox, K. H., Hughes, C. L., Richmond, W., Johnston, D. G. (1997). Fasting and Postprandial Lipid Abnormalities in Hypopituitary Women Receiving Conventional Replacement Therapy. J. Clin. Endocrinol. Metab. 82: 2653-2659 [Abstract] [Full text]  
• Jousilahti, P., Rastenyte, D., Tuomilehto, J., Sarti, C., Vartiainen, E. (1997). Parental History of Cardiovascular Disease and Risk of Stroke : A Prospective Follow-up of 14 371 Middle-aged Men and Women in Finland. Stroke 28: 1361-1366 [Abstract] [Full text]  
• (1997). Stroke Incidence and Mortality Correlated to Stroke Risk Factors in the WHO MONICA Project : An Ecological Study of 18 Populations. Stroke 28: 1367-1374 [Abstract] [Full text]  
• Fraser, J. D., Keller, D., Martinez, V., Santiso-Mere, D., Straney, R., Briggs, M. R. (1997). Utilization of Recombinant Adenovirus and Dominant Negative Mutants to Characterize Hepatocyte Nuclear Factor 4-regulated Apolipoprotein AI and CIII Expression. J. Biol. Chem. 272: 13892-13898 [Abstract] [Full text]  
• Tanne, D., Yaari, S., Goldbourt, U. (1997). High-Density Lipoprotein Cholesterol and Risk of Ischemic Stroke Mortality: A 21-Year Follow-up of 8586 Men From the Israeli Ischemic Heart Disease Study. Stroke 28: 83-87 [Abstract] [Full text]  
• Njolstad, I., Arnesen, E., Lund-Larsen, P. G. (1996). Body Height, Cardiovascular Risk Factors, and Risk of Stroke in Middle-aged Men and Women: A 14-Year Follow-up of the Finnmark Study. Circulation 94: 2877-2882 [Abstract] [Full text]  
• Garber, A M, Avins, A L (1994). Triglyceride concentration and coronary heart disease. BMJ 309: 2-3 [Full text]