BMJ  2003;327:1348 (6 December), doi:10.1136/bmj.327.7427.1348-a

Letter

Dietary fat intake and risk of stroke

Association may differ with subtypes of ischaemic stroke

EDITOR—He et al report no association between dietary fat intake and risk of stroke in men but did not analyse their data with reference to the different subtypes of ischaemic stroke.¹ The association between serum cholesterol concentrations and the various subtypes of ischaemic stroke may differ.

Sacco et al reported that the protective effect of high density lipoprotein cholesterol is more pronounced in preventing ischaemic stroke due to atherosclerosis compared with lacunar infarction, cryptogenic infarction, and cardioembolic stroke.² It may be interesting to ascertain if any of the different subtypes of ischaemic stroke are associated with dietary fat intake.

The proportion of subjects prescribed cholesterol lowering drugs is not stated by He et al. The result of the heart protection study showed a relation between cholesterol reduction with simvastatin and stroke prevention.³ Those with a high fat dietary intake might be more likely to be prescribed statins, and this may account, in part, for their reported lack of association between dietary fat intake and risk of stroke.

Springfield Unit, City General Hospital, Stoke-on-Trent ST4 6QG elliotepstein832{at}hotmail.com

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Competing interests: None declared.

References

1. He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willet WC, et al. Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ 2003;327: 777-82. (4 October.)[Abstract/Free Full Text]
2. Sacco RL, Benson RT, Kargman DE, Boden-Albala B, Tuck C, et al. High-density lipoprotein cholesterol and ischaemic stroke in the elderly: the Northern Manhattan Stroke Study. JAMA 2001;285: 2729-36.[Abstract/Free Full Text]
3. Heart Protection Study Collaborative Group. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20,536 high risk individuals: a randomised placebo-controlled trial. Lancet 2002;360: 7-22.[CrossRef][ISI][Medline]

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Relevant Article

Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study

Ka He, Anwar Merchant, Eric B Rimm, Bernard A Rosner, Meir J Stampfer, Walter C Willett, and Alberto Ascherio
BMJ 2003 327: 777-782. [Abstract] [Full Text] [PDF]

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