Role of dyslipidemia in stroke and comparison of lipid profile in ischemic and hemorrhagic stroke -a case control study

Mary Grace, K. J. Jacob, Arya Vijay Kumar, Shameer V. K.


Background: The role of dyslipidemia as a risk factor for stroke is questionable. One of the reasons could be that most studies club together ischemic and hemorrhagic stroke. In India, now there is an increase in the burden of cerebrovascular disease. Hence it is very important that we should have a thorough knowledge of the risk factors for stroke and the ways of preventing its occurrence. Objective of the study was to know whether there is a role for dyslipidemia in the occurrence of stroke and if there is any difference in the lipid profile of patients with ischemic and hemorrhagic stroke.

Methods: Case control study with 60 patients having hemorrhage and 60 patients with infarct and 73 controls. The patients in both the groups did not have diabetes and were not taking statins.

Results: Of the 120 patients with stroke 51 (42.5%) had cholesterol levels >200mg% OR 3.75 (1.83-7.7) p <0.001 and 77 (64.2%) had LDL cholesterol >100 mg% OR 2.29 (1.27-4.15) p 0.009. In the HDL-C category 32 (26.7%) had HDL less than 40 mg% while in the control group 30 (41.1%) had low HDL cholesterol OR 0.52 (0.28-0.96) p  0.05 . There was no difference in the lipid profile of ischemia and hemorrhage.

Conclusions: High total and LDL cholesterol are important risk factors in the development of stroke be it infarct or hemorrhage. HDL levels influence the development of hemorrhagic stroke but not infarct. There was no difference in the lipid profile of the two categories of stroke. Low HDL cholesterol is protective in hemorrhagic stroke.


Ischemic stroke, Cerebral hemorrhage, Lipid profile, Cholesterol, HDL cholesterol, LDL cholesterol, Triglyceride

Full Text:



García-Moll X. Inflammation, Atherosclerosis, Classic Cardiovascular Risk Factors, Biostatistics, Clinical Significance. Where Are We? Rev Esp Cardiol. 2007;60(12):1220-2.

Banerjee TK, Mukherjee CS, Sarkhel A. Stroke in the urban population of Calcutta-and epidemiological study. Neuroepidemiology. 2001;20:201-7.

Austin MA, King MC, Vranizan KM, Krauss RM. Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk. Circulation. 1990;82:495-506.

Musunuru K. Atherogenic Dyslipidemia: Cardiovascular Risk and Dietary Intervention Lipids. 2010;45(10):907-14.

Togha M, Gheini MR, Ahmadi B, Razeghi PKS. Lipid profile in cerebrovascular accidents Iran J Neurol. 2011;10(1-2):1-4.

Iso H, Jacobs DR, Wentworth D, Neaton JD, Cohen JD. for the MRFIT Research Group. Serum cholesterol levels and sixyear mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial. N Engl J Med. 1989;320:904-10.

Pedersen TR. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). The Lancet. 1994;344(8934):1383-9.

Amarenco P, Bogousslavsky J, Callahan A 3rd, Goldstein LB, Hennerici M, Rudolph AE, et al., “High-dose atorvastatin after stroke or transient ischemic attack,” The New England Journal of Medicine. 2006;355(6):549-59.

Pandian JD, Sudhan P. Stroke epidemiology and stroke care services in India. Journal of Stroke. 2013;15:128-34.

Wasay M, Khatri IA, Kaul S. Stroke in South Asian countries. Nat Rev Neurol. 2014;10:135-43.

Togha M, Gheini MR, Ahmadi B, Khashaiar P, Razeghi S. Lipid profile in cerebrovascular accidents. Iran J Neurol. 2011;10(1-2):1-4.

Okumura K, Iseki K, Wakugami K, Kimura Y, Muratani H, Ikemiya Y, et al. Low serum cholesterol as a risk factor for hemorrhagic stroke in men: A community-based mass screening in Okinawa, Japan. JpnCirc J. 1999; 63(1):53-8

Jayachandra G, Mohan C, Gowda VKM, Raghavendra B, Viswanatha Reddy N. “Study of Lipid Profile Components in Relation with Type of Stroke.” Journal of Evolution of Medical and Dental Sciences. 2015;4(95):16013-6.

Lindenstrom E, Boysen G, Nyboe J. Influence of total cholesterol, high-density lipoprotein cholesterol, and triglyceride on risk of cerebrovascular disease. BMJ. 1994;309:11-5.

Denti L, Cecchetti A, Annoni V, Merli MF, Ablondi F, Valenti G. The role of lipid profile in determining the risk of ischemic stroke in the elderly: a case/control study. Arch Gerontol Geriatr. 2003;37:51-62.

Voight BF, Peloso GM, Orho-Melander M, Frikke-Schmidt R, Barbalic M, Jensen MK, et al Plasma HDL cholesterol and risk of myocardial infarction: A mendelian randomisation study The Lancet. 2012;380(9841):572-80.