Total and High-Density Lipoprotein Cholesterol and Stroke Risk

Background and Purpose—The association of total and high-density lipoprotein (HDL) cholesterol with stroke risk is unclear, especially regarding hemorrhagic stroke. Methods—We prospectively investigated the associations of serum total and HDL cholesterol and total/HDL cholesterol ratio with total and type-specific stroke incidence among 58 235 Finnish people aged 25 to 74 years and free of coronary heart disease and stroke at baseline. Results—During a mean follow-up period of 20.1 years, 3914 participants developed stroke events (3085 ischemic, 497 intracerebral hemorrhage, and 332 subarachnoid hemorrhage). The multivariable-adjusted hazard ratios at different levels of total cholesterol (<5 [reference], 5–5.9, 6–6.0, ≥7.0 mmol/L) were 1.00, 1.05, 1.16, and 1.22 for total stroke (Ptrend=0.036) and 1.00, 1.06, 1.19, and 1.27 for ischemic stroke (Ptrend=0.02) in men and 1.00, 0.58, 0.61, and 0.50 for intracerebral hemorrhagic stroke (Ptrend=0.02) in women, respectively. Low levels of HDL cholesterol and hi...