Blood lipids and ischemic cerebrovascular disease

The purpose of this review is to evaluate whether blood lipids are risk factors for ischemic cerebrovascular disease in patients with chronic coronary heart disease. Patients with documented coronary heart disease who were screened for but not included in a secondary prevention trial, and had no history of stroke or transient ischemic attack (n = 11,177) were followed-up. At baseline, medical histories were obtained and blood lipids assessed at a central study laboratory. During a 6- to 8-year follow-up period 941 cases were identified with nonhemorrhagic cerebrovascular disease, of which 487 cases had verified ischemic stroke or transient ischemic attack. The age-adjusted incidence rates of ischemic stroke or transient ischemic attack rose with increasing levels of baseline triglycerides and total cholesterol and with decreasing levels of high-density lipoprotein (HDL) cholesterol and percentage of total serum cholesterol contained in HDL (%HDL). In logistic regression models, adjusting for clinical covariates, the following odds ratios (95% confidence intervals) were identified for lipid values in the upper versus the lower tertile for the end point of nonhemorrhagic cardiovascular disease: total cholesterol, 1.43 (1.20-1.70); low-density lipoprotein cholesterol, 1.52 (1.27-1.81), HDL, cholesterol 0.84 (0.70-1.00); %HDL, 0.69 (0.58-0.83); and triglycerides, 1.27 (1.07-1.51). Similar trends appeared for the end point of verified ischemic stroke/transient ischemic attack. The authors concluded that blood lipids are important predictors of ischemic cerebrovascular disease among patients with preexisting coronary heart disease.