low LDL and haemorrhagic stroke

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  • Intraparenchymal hemorrhage, which has a low survival rate and a high risk of disability, has unique pathological and epidemiological characteristics that distinguish it from coronary heart disease
    • type of stroke is caused primarily by hypertension and possibly by low concentrations of low-density lipoprotein (LDL) cholesterol (1,2)

  • low LDL cholesterol levels are associated with elevated risk of death due to haemorrhagic stroke (particularly intraparenchymal hemorrhage) (3)
    • however there was no association between subarachnoid haemorrage and low LDL choleserol levels
      • the study revealed a U-shaped relationship between LDL cholesterol and combined death due to intraparenchymal hemorrhage and coronary heart disease, with a nadir at LDL cholesterol levels of 120 to 139 mg/dL (3.10 to 3.61 mmol/L), because these 2 outcomes have an opposite direction in the association with LDL cholesterol (3)
      • however in this Japan based study, the authors observed inverse associations of LDL cholesterol with death due to total cardiovascular disease and all-cause mortality, because the Japanese population had high rates of death due to total stroke, with a high proportion of intraparenchymal hemorrhage, and low rates of death due to coronary heart disease compared with Americans
        • a previous study of Americans showed a U-shaped relationship between LDL cholesterol and all-cause mortality, with a nadir at LDL cholesterol levels of 160 to 189 mg/dL (4.14 to 4.90 mmol/L) for men and 130 to 159 mg/dL (3.36 to 4.12 mmol/L) for women (4)
    • the authors concluded that low LDL cholesterol may be an independent risk factor for intraparenchymal hemorrhage (3)

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Last edited 11/2018 and last reviewed 04/2022

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