The association between HDL‐C and stroke in the middle‐aged and elderly: A cross‐sectional study
Authors:
Open Access
- 7 February 2023
- journal article
- research article
- Published by Wiley in Brain and Behavior
- Vol. 13 (3) , e2901
Abstract
Background: Previous epidemiological studies have indicated that high‐density lipoprotein cholesterol (HDL‐C) is inversely associated with the risk of cardiovascular disease. However, this issue has aroused controversy in recent years. Besides, the relationship between HDL‐C and the risk of total stroke in sex and race is less clear. Thus, we aimed to examine the association between different ranges of HDL‐C and the risk of total stroke in adults over 40 years old.Methods: This cross‐sectional study was conducted on a sample of 8643 participants (4222 men and 4421 women) aged ≥40 years old from the National Health and Nutrition Examination Survey 2007–2016. HDL‐C was an independent variable and stroke was a dependent variable in this study, with the other variables as potential effect modifiers. To examine the associations between them, we used multivariate logistical regression models and smooth curve fittings, as well as subgroup analyses.Results: HDL‐C was inversely associated with stroke when HDL‐C was less than 1.55 mmol/L (odds ratio [OR] = 0.36, 95% confidence interval [CI] :0.21–0.62, p < .05). However, above 1.55 mmol/L, the incidence of stroke was not significant (OR = 1.29, 95% CI: 0.79–2.09, p>.05). Stratified by race/ethnicity and sex, the subgroup analyses demonstrated that HDL‐C was inversely associated with stroke in men and Whites, but no significant differences among women, Mexicans, blacks, and other races.Conclusion: We found a nonlinear relationship between HDL‐C and total stroke. Our study reveals a range of inverse associations between HDL‐C and stroke (HDL‐C<1.55 mmol/L), especially among men and Whites. This finding suggested that maintaining an appropriate HDL‐C range may be beneficial in reducing the incidence of stroke.Keywords
This publication has 24 references indexed in Scilit:
- Coronary Heart Disease Risks Associated with High Levels of HDL CholesterolJournal of the American Heart Association, 2014
- Cholesterol Levels and Risk of Hemorrhagic StrokeStroke, 2013
- High-density Lipoprotein Subclasses and Risk of Stroke and its Subtypes in Japanese PopulationStroke, 2013
- Total and High-Density Lipoprotein Cholesterol and Stroke RiskStroke, 2012
- Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control studyThe Lancet, 2010
- HDL as a Biomarker, Potential Therapeutic Target, and TherapyDiabetes, 2009
- Cholesterol and the Risk of Ischemic StrokeStroke, 2003
- Menopause and Risk Factors for Coronary Heart DiseaseNew England Journal of Medicine, 1989
- Coping with conflict situations: Middle-aged and elderly men.Psychology and Aging, 1989
- High Density Lipoprotein-2 and Hepatic Lipase: Reciprocal Changes Produced by Estrogen and Norgestrel*The Journal of Clinical Endocrinology & Metabolism, 1982