Cholesterol Predicts Stroke Mortality in the Women’s Pooling Project

Author:

Horenstein Richard B.1,Smith Dean E.1,Mosca Lori1

Affiliation:

1. From the Department of Medicine, University of Maryland Medical System, Baltimore (R.B.H.); Department of Medicine, University of Michigan Health System, Ann Arbor (D.E.S.); and Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY (L.M.).

Abstract

Background and Purpose Cholesterol is emerging as a risk factor for stroke; however, few data are available regarding the relation of cholesterol and stroke mortality in women and ethnic minorities. Methods We evaluated the risk of death caused by total stroke, nonhemorrhagic stroke, and hemorrhagic stroke by race, age, and cholesterol quintile in 24 343 women with no previous cardiovascular disease who were participating in 8 US longitudinal, prospective, cohort studies included in the Women’s Pooling Project. Results We observed 568 stroke deaths (461 nonhemorrhagic, 83 hemorrhagic) for women ≥30 years of age without previous cardiovascular disease during 339 215 person-years of follow-up. In multivariate models, black women <55 years of age had a 76% increased risk of death caused by stroke compared with white women [relative risk (RR), 1.76; 95% confidence interval (CI), 1.10 to 2.81]. For black women <55 years of age, the top compared with the lowest cholesterol quintile (Q5 versus Q1) remained an independent predictor of stroke mortality (RR, 2.58; 95% CI, 1.05 to 6.32) in multivariate models. For white women <55 years of age, Q5 versus Q1 cholesterol did not predict stroke mortality with significance (RR, 1.47; 95% CI, 0.57 to 3.76). In analogous multivariate models, we found a positive relation between continuous cholesterol and nonhemorrhagic stroke death in women <55 years of age (RR, 1.23; 95% CI, 1.02 to 1.49). Conclusions Our results show that cholesterol is a risk factor for nonhemorrhagic stroke death in women <55 years of age and is more strongly associated with mortality in black women <55 years of age than in white women. These data document the importance of cholesterol in addition to established risk factors for predicting stroke mortality in young women and may guide prevention strategies.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference45 articles.

1. American Heart Association. 2000 Heart and Stroke Statistical Update Dallas Tex.: American Heart Association; 1999.

2. Primary Prevention of Stroke

3. Risk Factors for Stroke in Blacks: A Critical Review

4. Cholesterol Reduction: Weighing the Benefits and Risks

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