HDL-cholesterol, total cholesterol, and the risk of stroke in middle-aged British men
The purpose of this study was to examine the relation between serum HDL cholesterol and total cholesterol and risk of stroke. We carried out a prospective study in 7735 men, 40 to 59 years of age, drawn from 1 group practice in each of 24 British towns. Men with history of stroke were excluded (n=52...
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| Veröffentlicht in: | Stroke (1970) 2000-08, Vol.31 (8), p.1882-1888 |
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| creator | WANNAMETHEE, S. G SHAPER, A. G EBRAHIM, S |
| description | The purpose of this study was to examine the relation between serum HDL cholesterol and total cholesterol and risk of stroke.
We carried out a prospective study in 7735 men, 40 to 59 years of age, drawn from 1 group practice in each of 24 British towns. Men with history of stroke were excluded (n=52).
During the mean follow-up period of 16.8 years, there were 343 stroke cases (fatal and nonfatal) in the 7683 men with no history of stroke. Higher levels of HDL cholesterol were associated with a significant decrease in risk of stroke even after adjustment for potential confounders (top fifth versus lowest fifth: adjusted relative risk=0.68, 95% CI 0.46 to 0.99). The inverse relation was seen only for nonfatal strokes (adjusted relative risk=0.59, 95% CI 0.39 to 0.90; top fifth versus lowest fifth). Total cholesterol showed no graded association with fatal strokes, but men with levels > or =8.1 mmol/L (top 5% of the distribution) showed increased risk of nonfatal stroke, although this was not statistically significant after adjustment (adjusted RR=1.46, 95% CI 0.91 to 2.32). The beneficial effects of elevated HDL cholesterol on nonfatal stroke were seen in both smokers and nonsmokers and were more evident in men with hypertension than in normotensives. In hypertensive men, elevated HDL cholesterol (top fifth) was associated with a significant 50% reduction in risk of nonfatal strokes compared with men in the lowest fifth.
Higher levels of HDL cholesterol were associated with a significant decrease in risk of nonfatal stroke. In contrast, elevated total cholesterol showed a weak positive association with nonfatal strokes. The marked inverse association between HDL cholesterol and stroke seen in hypertensives emphasizes the importance of those modifiable risk factors for stroke known to lower the concentrations of HDL cholesterol. |
| doi_str_mv | 10.1161/01.str.31.8.1882 |
| format | Article |
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We carried out a prospective study in 7735 men, 40 to 59 years of age, drawn from 1 group practice in each of 24 British towns. Men with history of stroke were excluded (n=52).
During the mean follow-up period of 16.8 years, there were 343 stroke cases (fatal and nonfatal) in the 7683 men with no history of stroke. Higher levels of HDL cholesterol were associated with a significant decrease in risk of stroke even after adjustment for potential confounders (top fifth versus lowest fifth: adjusted relative risk=0.68, 95% CI 0.46 to 0.99). The inverse relation was seen only for nonfatal strokes (adjusted relative risk=0.59, 95% CI 0.39 to 0.90; top fifth versus lowest fifth). Total cholesterol showed no graded association with fatal strokes, but men with levels > or =8.1 mmol/L (top 5% of the distribution) showed increased risk of nonfatal stroke, although this was not statistically significant after adjustment (adjusted RR=1.46, 95% CI 0.91 to 2.32). The beneficial effects of elevated HDL cholesterol on nonfatal stroke were seen in both smokers and nonsmokers and were more evident in men with hypertension than in normotensives. In hypertensive men, elevated HDL cholesterol (top fifth) was associated with a significant 50% reduction in risk of nonfatal strokes compared with men in the lowest fifth.
Higher levels of HDL cholesterol were associated with a significant decrease in risk of nonfatal stroke. In contrast, elevated total cholesterol showed a weak positive association with nonfatal strokes. The marked inverse association between HDL cholesterol and stroke seen in hypertensives emphasizes the importance of those modifiable risk factors for stroke known to lower the concentrations of HDL cholesterol.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.str.31.8.1882</identifier><identifier>PMID: 10926951</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Age Factors ; Biological and medical sciences ; Biomarkers - blood ; Body Mass Index ; Cholesterol - blood ; Cholesterol, HDL - blood ; Coronary Disease - blood ; Coronary Disease - complications ; Coronary Disease - epidemiology ; Diabetes Complications ; Diabetes Mellitus - blood ; Diabetes Mellitus - epidemiology ; Humans ; Hyperlipidemias - blood ; Hyperlipidemias - complications ; Hyperlipidemias - epidemiology ; Incidence ; Male ; Medical sciences ; Middle Aged ; Neurology ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Stroke - blood ; Stroke - epidemiology ; Stroke - etiology ; Surveys and Questionnaires ; Survival Rate ; Triglycerides - blood ; United Kingdom - epidemiology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2000-08, Vol.31 (8), p.1882-1888</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Aug 2000</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-f020ef2ba4a367e005878565fd7abf91ba920a278b0e9bc117796a5ccd808a303</citedby><cites>FETCH-LOGICAL-c495t-f020ef2ba4a367e005878565fd7abf91ba920a278b0e9bc117796a5ccd808a303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1449845$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10926951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WANNAMETHEE, S. G</creatorcontrib><creatorcontrib>SHAPER, A. G</creatorcontrib><creatorcontrib>EBRAHIM, S</creatorcontrib><title>HDL-cholesterol, total cholesterol, and the risk of stroke in middle-aged British men</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>The purpose of this study was to examine the relation between serum HDL cholesterol and total cholesterol and risk of stroke.
We carried out a prospective study in 7735 men, 40 to 59 years of age, drawn from 1 group practice in each of 24 British towns. Men with history of stroke were excluded (n=52).
During the mean follow-up period of 16.8 years, there were 343 stroke cases (fatal and nonfatal) in the 7683 men with no history of stroke. Higher levels of HDL cholesterol were associated with a significant decrease in risk of stroke even after adjustment for potential confounders (top fifth versus lowest fifth: adjusted relative risk=0.68, 95% CI 0.46 to 0.99). The inverse relation was seen only for nonfatal strokes (adjusted relative risk=0.59, 95% CI 0.39 to 0.90; top fifth versus lowest fifth). Total cholesterol showed no graded association with fatal strokes, but men with levels > or =8.1 mmol/L (top 5% of the distribution) showed increased risk of nonfatal stroke, although this was not statistically significant after adjustment (adjusted RR=1.46, 95% CI 0.91 to 2.32). The beneficial effects of elevated HDL cholesterol on nonfatal stroke were seen in both smokers and nonsmokers and were more evident in men with hypertension than in normotensives. In hypertensive men, elevated HDL cholesterol (top fifth) was associated with a significant 50% reduction in risk of nonfatal strokes compared with men in the lowest fifth.
Higher levels of HDL cholesterol were associated with a significant decrease in risk of nonfatal stroke. In contrast, elevated total cholesterol showed a weak positive association with nonfatal strokes. The marked inverse association between HDL cholesterol and stroke seen in hypertensives emphasizes the importance of those modifiable risk factors for stroke known to lower the concentrations of HDL cholesterol.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Body Mass Index</subject><subject>Cholesterol - blood</subject><subject>Cholesterol, HDL - blood</subject><subject>Coronary Disease - blood</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - epidemiology</subject><subject>Diabetes Complications</subject><subject>Diabetes Mellitus - blood</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Humans</subject><subject>Hyperlipidemias - blood</subject><subject>Hyperlipidemias - complications</subject><subject>Hyperlipidemias - epidemiology</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Stroke - blood</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>Surveys and Questionnaires</subject><subject>Survival Rate</subject><subject>Triglycerides - blood</subject><subject>United Kingdom - epidemiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLxDAUhYMoOj72riSIuLL13jRpkqVvhQFBx3VI29Spto0mnYX_3g4z4GN14fKdB4eQQ4QUMcdzwDQOIc0wVSkqxTbIBAXjCc-Z2iQTgEwnjGu9Q3ZjfAMAlimxTXYQNMu1wAl5ub-eJuXcty4OLvj2jA5-sC3987J9RYe5o6GJ79TXdMz07442Pe2aqmpdYl9dRS9DMzRxTjvX75Ot2rbRHazvHnm5vZld3SfTx7uHq4sxkWsxJDUwcDUrLLdZLh2AUFKJXNSVtEWtsbCagWVSFeB0USJKqXMryrJSoGwG2R45Xfl-BP-5GPuaromla1vbO7-IRiLTTMMSPP4HvvlF6MduBrVUnEkpRghWUBl8jMHV5iM0nQ1fBsEs9zaA5nn2ZDI0yiz3HiVHa99F0bnql2A18AicrAEbS9vWwfZlE384zrXiIvsGq9mHHA</recordid><startdate>20000801</startdate><enddate>20000801</enddate><creator>WANNAMETHEE, S. G</creator><creator>SHAPER, A. G</creator><creator>EBRAHIM, S</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20000801</creationdate><title>HDL-cholesterol, total cholesterol, and the risk of stroke in middle-aged British men</title><author>WANNAMETHEE, S. G ; SHAPER, A. G ; EBRAHIM, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-f020ef2ba4a367e005878565fd7abf91ba920a278b0e9bc117796a5ccd808a303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Body Mass Index</topic><topic>Cholesterol - blood</topic><topic>Cholesterol, HDL - blood</topic><topic>Coronary Disease - blood</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - epidemiology</topic><topic>Diabetes Complications</topic><topic>Diabetes Mellitus - blood</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Humans</topic><topic>Hyperlipidemias - blood</topic><topic>Hyperlipidemias - complications</topic><topic>Hyperlipidemias - epidemiology</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Stroke - blood</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>Surveys and Questionnaires</topic><topic>Survival Rate</topic><topic>Triglycerides - blood</topic><topic>United Kingdom - epidemiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WANNAMETHEE, S. G</creatorcontrib><creatorcontrib>SHAPER, A. G</creatorcontrib><creatorcontrib>EBRAHIM, S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WANNAMETHEE, S. G</au><au>SHAPER, A. G</au><au>EBRAHIM, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HDL-cholesterol, total cholesterol, and the risk of stroke in middle-aged British men</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2000-08-01</date><risdate>2000</risdate><volume>31</volume><issue>8</issue><spage>1882</spage><epage>1888</epage><pages>1882-1888</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>The purpose of this study was to examine the relation between serum HDL cholesterol and total cholesterol and risk of stroke.
We carried out a prospective study in 7735 men, 40 to 59 years of age, drawn from 1 group practice in each of 24 British towns. Men with history of stroke were excluded (n=52).
During the mean follow-up period of 16.8 years, there were 343 stroke cases (fatal and nonfatal) in the 7683 men with no history of stroke. Higher levels of HDL cholesterol were associated with a significant decrease in risk of stroke even after adjustment for potential confounders (top fifth versus lowest fifth: adjusted relative risk=0.68, 95% CI 0.46 to 0.99). The inverse relation was seen only for nonfatal strokes (adjusted relative risk=0.59, 95% CI 0.39 to 0.90; top fifth versus lowest fifth). Total cholesterol showed no graded association with fatal strokes, but men with levels > or =8.1 mmol/L (top 5% of the distribution) showed increased risk of nonfatal stroke, although this was not statistically significant after adjustment (adjusted RR=1.46, 95% CI 0.91 to 2.32). The beneficial effects of elevated HDL cholesterol on nonfatal stroke were seen in both smokers and nonsmokers and were more evident in men with hypertension than in normotensives. In hypertensive men, elevated HDL cholesterol (top fifth) was associated with a significant 50% reduction in risk of nonfatal strokes compared with men in the lowest fifth.
Higher levels of HDL cholesterol were associated with a significant decrease in risk of nonfatal stroke. In contrast, elevated total cholesterol showed a weak positive association with nonfatal strokes. The marked inverse association between HDL cholesterol and stroke seen in hypertensives emphasizes the importance of those modifiable risk factors for stroke known to lower the concentrations of HDL cholesterol.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10926951</pmid><doi>10.1161/01.str.31.8.1882</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association; Journals@Ovid Complete; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Adult Age Factors Biological and medical sciences Biomarkers - blood Body Mass Index Cholesterol - blood Cholesterol, HDL - blood Coronary Disease - blood Coronary Disease - complications Coronary Disease - epidemiology Diabetes Complications Diabetes Mellitus - blood Diabetes Mellitus - epidemiology Humans Hyperlipidemias - blood Hyperlipidemias - complications Hyperlipidemias - epidemiology Incidence Male Medical sciences Middle Aged Neurology Proportional Hazards Models Prospective Studies Risk Factors Stroke - blood Stroke - epidemiology Stroke - etiology Surveys and Questionnaires Survival Rate Triglycerides - blood United Kingdom - epidemiology Vascular diseases and vascular malformations of the nervous system |
| title | HDL-cholesterol, total cholesterol, and the risk of stroke in middle-aged British men |
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