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LDL below 70 mg/dL increases hemorrhagic stroke risk
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Patients with LDL concentrations less than 70 mg/dL had an increased risk for intracerebral hemorrhage, which became nonsignificant once LDL levels surpassed 70 mg/dL, according to a study published in Neurology.
“As is true with many things in nutrition, moderation and balance is key when deciding the optimal target level of LDL cholesterol,” Xiang Gao, MD, PhD, associate professor of nutritional sciences and director of the Nutritional Epidemiology Lab at Penn State University, said in a press release. “You can’t go to either extreme — too high or too low. And if you’re at a high risk for hemorrhagic stroke due to family history or risk factors like high blood pressure and heavy alcohol drinking, you may want to be extra careful about LDL cholesterol levels.”
Chaoran Ma, MD, nutritional sciences graduate student at Penn State University, and colleagues analyzed data from 96,043 participants who were free from MI, stroke and cancer at baseline in 2006, when a physical examination, standardized questionnaire and laboratory tests were conducted. Follow-up was conducted biannually including blood samples to measure LDL, HDL, total cholesterol and triglycerides.
An outcome of interest was the first occurrence of intracerebral hemorrhage.
During 9 years of follow-up, there were 753 cases of intracerebral hemorrhage.
Participants with LDL concentrations between 70 mg/dL and 99 mg/dL had a similar risk for intracerebral hemorrhage compared with those with concentrations of at least 100 mg/dL. The risk for intracerebral hemorrhage was significantly higher in participants with LDL concentrations less than 70 mg/dL compared with those with concentrations between 70 mg/dL and 90 mg/dL. The HR for concentrations between 50 mg/dL and 69 mg/dL was 1.65 (95% CI, 1.32-2.05) and 2.69 for those with concentrations less than 50 mg/dL (95% CI, 2.03-3.57).
“These results could be important in determining a target of LDL-C range, especially in patients with atherosclerotic disease who might be at higher baseline [intracerebral hemorrhage] risk such as aging individuals, those with hypertension and people with high alcohol drinking,” Ma and colleagues wrote. “Future studies with large sample sizes with categorical information on parenchymal hematoma location and conducted among other populations would be appropriate to further investigate this association.” – by Darlene Dobkowski
Disclosure s : Gao reports he served on a committee of the Parkinson Study Group and received funding from the NIH/National Institute of Neurological Disorders and Stroke. Ma reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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