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In Framingham cohort, HDL - not LDL - linked with stroke
New data from the prospective Framingham Heart Study show a possible link between
ischemic stroke and HDL levels -- but not between stroke and total cholesterol, LDL, or triglycerides.
The findings, presented yesterday at the American Neurological Association Annual Meeting, showed a heightened risk of
ischemic stroke with high-density lipoprotein (HDL) levels of 40 mg/dL or lower. Dr. Bernadette Boden-Albala, a neurologist who specializes in social epidemiology at The Mount Sinai School of Medicine in New York, said her own research has suggested a link between HDL and ischemic stroke risk in case-control designs, but not prospectively.
"What remains interesting is the importance of HDL as a component of Metabolic Syndrome and that may be part of what is going on in this study as well," Dr. Boden-Albala, who wasn't involved in the new research, told Reuters Health in an email.
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On multivariate analysis, HDL levels at or below 40 mg/dL were associated with a significantly increased risk of incident ischemic stroke (HR, 1.58; p less than0.001), a finding consistent in men and women and each age group.
Low HDL was also linked to atherothrombotic brain infarctions and cardioembolic infarctions, in particular.
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"We should pay attention to HDL levels, more so than to LDL levels, for primary prevention," Dr. Pikula told Reuters Health.
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Dr. Larry Goldstein, director of the Duke Stroke Center in Durham, North Carolina, said the link between cholesterol and stroke remains a "moving target."
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