Cholesterol and risk of stroke: The Japanese comparison

doi:10.1136/bmj.333.7559.148-b

BMJ 2006;333:148-149 (15 July), doi:10.1136/bmj.333.7559.148-b

Letter

Cholesterol and risk of stroke

The Japanese comparison

The first 150 words of the full text of this article appear below.

EDITOR—Yet again, a potential relation between low cholesterolconcentrations and haemorrhagic stroke is dismissed.¹ Yet again,a causal relation between high cholesterol concentrations, ischaemicstroke, and coronary heart disease is (apparently) confirmed.

Yet data from Japan directly contradicts Ebrahim et al's conclusions.From 1958 to 1995 fat consumption increased from 5% to 20% ofthe total daily energy consumption, and cholesterol concentrationsrose from 3.9 mmol/l to 5.0 mmol/l.² During this period therate of stroke (combined) fell from 1344/100 000/year to 205/100000/year in those aged 60-69. This is a 6.5-fold reduction inthe rate of stroke.³ (There was also a decrease in death ratefrom coronary heart disease.)

The possibility that increased fat consumption was the causalfactor in reducing the rate of stroke is strongly supportedby a study in Stroke, which concluded that: "A high consumptionof animal fat and cholesterol was associated . . . [Full text of this article]

Malcolm E Kendrick, general practitioner

Benchill Medical Centre, Wythenshawe M22 7WP malcolmken@doctors.org.uk

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