High-Density Lipoprotein Cholesterol and the Risk of First Ischemic Stroke in a Chinese Hypertensive Population

• Published in: Clinical interventions in aging 2021-01, Vol.16, p.801-810
• Main Authors: Zhang, Yue, Li, Jingyi, Liu, Chengzhang, Yu, Hongxiang, Chen, Chen, Bi, Chonglei, Fang, Chongqian, Ma, Hai, Li, Aimin, Dong, Qing, Liu, Lishun, Wang, Binyan, Huang, Xiao, Cheng, Xiaoshu, Zalloua, Pierre, Xu, Xiping, Huo, Yong, Li, Gang
• Format: Article
• Language: English
• Subjects: Age; Aged; Aging; Antihypertensives; Biomarkers; Blood pressure; Body mass index; Cardiovascular disease; Case-Control Studies; China - epidemiology; Cholesterol; Cholesterol, HDL; Cholesterol, HDL - blood; Complications and side effects; Drugs; Epidemiology; Ethics; Female; Glucose; Health aspects; high-density lipoprotein cholesterol; Homocysteine; Humans; Hypertension; Hypertension - epidemiology; Hypertension - physiopathology; Ischemia; ischemic stroke; Ischemic Stroke - epidemiology; Ischemic Stroke - physiopathology; Lipids; Lipids - blood; Lipoproteins; Male; Medical laboratories; Middle Aged; Odds Ratio; Older people; Original Research; Population; Prevention; Risk Factors; Smoking; Statistical analysis; Stroke; Stroke (Disease); Surveillance; Variables
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S295252

Elevated high-density lipoprotein cholesterol (HDL-C) levels have displayed protection against cardiovascular disease. However, the association between specific lipoprotein classes and first ischemic stroke (IS) has not been well defined, particularly in higher-risk hypertensive populations. Our study evaluated the associations of HDL-C with first IS in a Chinese hypertensive population. The study population was obtained from a community-based cohort study of hypertension in Lianyungang and Rongcheng, China. A nested case-control design was used that included 2463 identified first IS cases and 2463 controls matched by age ± 1 year, sex, and region. After adjusting for potential confounders, HDL-C was inversely associated with first IS (adjusted odds ratio [aOR]: 0.91; 95% confidence interval [CI]: 0.85-0.98). HDL-C levels of at least 65.4 mg/dL displayed a significant protective effect for first IS (aOR: 0.82; 95% CI: 0.69-0.98). Conversely, adverse effects of first IS were observed for low-density lipoprotein cholesterol (LDL-C) levels ≥138.1 mg/dL (aOR: 1.20; 95% CI: 1.02-1.42) and triglyceride (TG) levels ≥140.8 mg/dL (aOR: 1.27; 95% CI: 1.09-1.49). The risk associations of LDL-C and TG with first IS were attenuated in the presence of high HDL-C (≥53.0 mg/dL); an increased risk of first IS was only found in the presence of low HDL-C (