This Article Full Text Full Text (PDF) All Versions of this Article: 35/6/1523    most recent 01.STR.0000130460.09807.ecv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Piechowski-Józwiak, B. Articles by Bogousslavsky, J. Search for Related Content PubMed PubMed Citation Articles by Piechowski-Józwiak, B. Articles by Bogousslavsky, J.

(Stroke. 2004;35:1523.)
© 2004 American Heart Association, Inc.

Controversies in Stroke

Cholesterol as a Risk Factor for Stroke

The Fugitive?

Bartomiej Piechowski-Jówiak, MD

From the Department of Neurology, Centre Hospitalier Univ Vaudois, Lausanne, Switzerland.

Correspondence to Julien Bogousslavsky, MD, Cerebrovascular Diseases Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Email julien.bogousslavsky@chuv.hospvd.ch

Key Words: stroke • incidence • lipid-lowering therapy • statins

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The burden of stroke is unquestionable in a myriad of aspects. Multiple stroke risk factors are known, and some of them are considered strong and primary while others are considered uncertain and secondary. Among the latter, there is hyperlipidemia. As the acute stroke treatment is costly, the saying that prevention is better than treatment bears a special meaning here. In this discussion, as prosecutors from our bar we stand to plead, "Cholesterol – guilty for stroke."

Several epidemiological studies demonstrated a correlation between increased blood total cholesterol levels and risk of myocardial infarction.^1,2 The association between cholesterol levels and stroke occurrence is debated in the literature. In the Framingham cohort no connection was found between the levels of cholesterol and the incidence of stroke.¹ Nonetheless, in young women, a positive correlation between total cholesterol levels and stroke-related mortality was observed, while in subjects in 6th and 7th decade of age, an inverse correlation between these parameters was found.³ The combined analysis of cohort trials showed no significant association between the increased level of serum cholesterol and stroke rate, except for patients younger than 45 years.⁴ However, this analysis did not stratify into stroke subgroups and thus a positive association with ischemic stroke might be offset by a negative association with hemorrhagic stroke. This was confirmed in a longitudinal study on men screened for multiple risk factors, as a positive correlation between total cholesterol levels and ischemic stroke risk, and a negative association between cholesterol level and occurrence of all hemorrhagic . . . [Full Text of this Article]

This article has been cited by other articles:

				T. S. Olsen, R. H. B. Christensen, L. P. Kammersgaard, and K. K. Andersen Response to Letter by Sheikh Stroke, March 1, 2008; 39(3): e63 - e63. [Full Text] [PDF]

				H.-C. Koennecke Cerebral microbleeds on MRI: Prevalence, associations, and potential clinical implications Neurology, January 24, 2006; 66(2): 165 - 171. [Abstract] [Full Text] [PDF]

				D. L. Tirschwell, N. L. Smith, S. R. Heckbert, R. N. Lemaitre, W. T. Longstreth Jr., and B. M. Psaty Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups Neurology, November 23, 2004; 63(10): 1868 - 1875. [Abstract] [Full Text] [PDF]