Stroke, Vol 20, 1460-1465, Copyright © 1989 by American Heart Association
K Yano, DM Reed and CJ MacLean
During an average 18 years of follow-up for 7,850 Japanese-American men in
Hawaii who were free of stroke at entry, 116 developed hemorrhagic stroke
(subarachnoid hemorrhage or intracerebral hemorrhage). There was a
significant (p = 0.001) inverse association between serum cholesterol and
the risk of intracerebral hemorrhage but not of subarachnoid hemorrhage.
This inverse association was nonlinear, with a higher incidence rate only
for men with serum cholesterol in the lowest quintile (less than 189
mg/dl). The relative risk (lowest quintile/other four quintiles) was 2.55
(95% confidence interval 1.58- 4.12) after controlling for age, blood
pressure, serum uric acid, cigarette smoking, and alcohol consumption.
There was no evidence for an interaction between blood pressure and serum
cholesterol, although the inverse association was stronger for normotensive
than for hypertensive men. Public health implications would differ in
different countries depending on the relative frequency of intracerebral
hemorrhage and on the distribution of serum cholesterol levels in the
population.
ARTICLES
Serum cholesterol and hemorrhagic stroke in the Honolulu Heart Program
Honolulu Heart Program, Kuakini Medical Center, Hawaii 96817.
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|
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|
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|
|
|
|
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|
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|
|
|
|
|
|
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|
|
|
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|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
M. F Oliver Cholesterol and strokes BMJ, February 19, 2000; 320(7233): 459 - 460. [Full Text]
|
|
|
|
|
|
J. M. Leppala, J. Virtamo, R. Fogelholm, D. Albanes, and O. P. Heinonen Different Risk Factors for Different Stroke Subtypes : Association of Blood Pressure, Cholesterol, and Antioxidants Stroke, December 1, 1999; 30(12): 2535 - 2540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Plehn, B. R. Davis, F. M. Sacks, J. L. Rouleau, M. A. Pfeffer, V. Bernstein, T. E. Cuddy, L. A. Moye, L. B. Piller, J. Rutherford, et al. Reduction of Stroke Incidence After Myocardial Infarction With Pravastatin : The Cholesterol and Recurrent Events (CARE) Study Circulation, January 19, 1999; 99(2): 216 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. K. Welty, C. Lahoz, K. L. Tucker, J. M. Ordovas, P. W. F. Wilson, and E. J. Schaefer Frequency of ApoB and ApoE Gene Mutations as Causes of Hypobetalipoproteinemia in the Framingham Offspring Population Arterioscler. Thromb. Vasc. Biol., November 1, 1998; 18(11): 1745 - 1751. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A Papadakis, D. P Mikhailidis, and A. F Winder Lipids and stroke: neglect of a useful preventive measure? Cardiovasc Res, November 1, 1998; 40(2): 265 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. K. Welty, M. A. Mittleman, P. W.F. Wilson, P. A. Sutherland, T. H. Matheney, I. Lipinska, J. E. Muller, D. Levy, and G. H. Tofler Hypobetalipoproteinemia Is Associated With Low Levels of Hemostatic Risk Factors in the Framingham Offspring Population Circulation, February 18, 1997; 95(4): 825 - 830. [Abstract] [Full Text]
|
|
|
|
|
|
W. I. Schievink Intracranial Aneurysms N. Engl. J. Med., January 2, 1997; 336(1): 28 - 40. [Full Text] [PDF]
|
|
|
|
|
|
C. Iribarren, D. R. Jacobs, M. Sadler, A. J. Claxton, and S. Sidney Low Total Serum Cholesterol and Intracerebral Hemorrhagic Stroke: Is the Association Confined to Elderly Men?: The Kaiser Permanente Medical Care Program Stroke, November 1, 1996; 27(11): 1993 - 1998. [Abstract] [Full Text]
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L. L. Teunissen, G. J.E. Rinkel, A. Algra, and J. van Gijn Risk Factors for Subarachnoid Hemorrhage : A Systematic Review Stroke, March 1, 1996; 27(3): 544 - 549. [Abstract] [Full Text]
|
|
|
|
|
|
L. L. Bronner, D. S. Kanter, and J. E. Manson Primary Prevention of Stroke N. Engl. J. Med., November 23, 1995; 333(21): 1392 - 1400. [Full Text] [PDF]
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|
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|
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C. Iribarren, D. M. Reed, R. Chen, K. Yano, and J. H. Dwyer Low Serum Cholesterol and Mortality : Which Is the Cause and Which Is the Effect? Circulation, November 1, 1995; 92(9): 2396 - 2403. [Abstract] [Full Text]
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E. Vartiainen, C. Sarti, J. Tuomilehto, and K. Kuulasmaa Do changes in cardiovascular risk factors explain changes in mortality from stroke in Finland? BMJ, April 8, 1995; 310(6984): 901 - 904. [Abstract] [Full Text]
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E Lindenstrom, G Boysen, and J Nyboe Influence of total cholesterol, high density lipoprotein cholesterol, and triglycerides on risk of cerebrovascular disease: the Copenhagen city heart study BMJ, July 2, 1994; 309(6946): 11 - 15. [Abstract] [Full Text]
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