Association between serum lipid and ischaemic stroke in a tertiary hospital in Northern Andhra Pradesh, India
Keywords:Hypercholesterolaemia, Ischaemic stroke, Risk factors
Background: The incidence of cerebrovascular disease increases with age and the number of strokes is projected to increase as the elderly population grows. A stroke occurs when blood vessels that carry blood to the brain suddenly blocked or burst, preventing blood flow to the brain. The most common cause of blood vessel blockages is thrombosis (a blood clot) or an embolism (floating clot). Blood clots may form in the arteries that are damaged by atherosclerosis. Atherosclerosis is an aging process but some factors (risk factor) precipitate it to occur earlier. To find out the risk factors properly are of tremendous importance as risk factor change could directly influence or indirectly affect case fatality by altering the natural history of the disease. Serum lipids are thought to interact with the pathogenesis of stroke through the atherosclerotic mechanism. Objective was to identify the high serum lipid as an independent risk factor of stroke.
Methods: This is a hospital-based case-control study. Seventy cases of stroke patients and age, sex-matched 70 healthy control subjects were enrolled by non-random sampling. 12 hours of fasting plasma lipids were estimated in both cases and control subjects. Then it was compared between cases and controls.
Results: Hypercholesterolemia was higher in the case group than control but not statistically significant. Mean LDL- cholesterol, and triglycerides were significantly higher in the case group than the control group. The mean value of serum HDL-cholesterol was not significantly lower in the case group than the control group.
Conclusions: Serum lipids are significantly higher in ischaemic stroke patients than the control group (LDL cholesterol and triglyceride). So, it may be an independent risk factor of ischemic stroke.
Smitah WS, Johnston SC, Easton JD, Cardiovascular disease. In: Kasper DL, Fauci AS, Long DL, Brainwald HE, Stephen L, Jamsen LL, (eds). Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw-Hill Medical Publishing Division; 2005:2372-93.
Mohammad QD. Course of the aging process. Bang Med J. 2003;32(4):68-9.
Mc Caron OM, Delong D and Alberts MJ. APO-E genotype as a risk factor for ischaemic cerebrovascular disease. Neurol. 1994;44:626-34.
Mohammad QD, Mannan MA, Fakir NH, Rahman HZ, Quarassi FA, Begum JA. Cerebral thrombosis and risk factors, Study of 12 cases. Bangladesh J Neurosci. 1987;3(2):48-54.
Albucheer FJ, Ferries J, Ruidavates JB, Chaumait GB, Perret PB, Cholvet F. Serum lipids in young Patents with ischaemic stroke a case control study. J Neural Neurosurg. 2000;69:29-33.
Rahman M, Mosharraf AKM, Hossain P, Ismail M. Risk factor for stroke –a clinical study. BJM. 2003;(14)2:36-40.
Robbins SL, Cotrain RS, Kumar V, Collins T. Disease of the blood vessels. In: Pocket companions to Robbins Pathologic Basis of dissease. Sixth ed. Philadelphia, Pensylvinia: W.B. Saunders Company; 1999;259-260.
Mayes PA, Botham KM, Rodwell VW. Harper’s Biochemistry. 26th ed. USA:McGraw-Hill Companies; 2003;205-218.
Chanu B. Hypertriglyceridemia; danger for the arteries. Cardiol Rev. 2002;10(3):163-72.
Geurian K, Pinson JB, Weast CW. The triglycerides connection in atherosclerosis. Stroke. 2003;34:105-10.
Morag NK, Eran C, Gold B. High blood triglycerides are independent risk factors for stroke. Circulation. 2002;26:6-7.
Latif ZA, Zaman SM, Ahad A, Rahim SA. Study of stroke between between normotensive and hypertensive NIDDM cases in BIRDEM. Dhaka, Bangladesh J Neurosci. 1990;6:52-9.
Mayer JS, Rgers RL, Mortel KF, Judd BW. Hyperlipidaemia is a risk factor for decreased cerebral perfusion and stroke. N Engl J Med. 1987;317:521-6.
Cazzato G, Zorzon M, Carraro N, Monit F. Dyslipidaemias and ischaemic cerebaral vasculopathy. Neurol. 1998;50:1694-98.
Grau AJ, Weimar C, Buggle F, Heinrich A, Goertler M, Neumaier S, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank. Stroke. 2001 Nov 1;32(11):2559-66.
Deuti L, Cecchethi A, Annoui V, Merli MF, Ablondi F, Valanti G. The role of upie profile in determing the risk of ischaemic stroke in the elderly; a cose control study. J Cardiovasc Risk. 1999;6:223-8.
Hachiuski V, Graffagniuo C, Beaudny M, Burmierk G, Buck C, Donner A, et al. lipids and stroke: a paradox resolved. Arch Neroal. 1996 Apr; 53(4):303-8.
Laloux P, Galanti L, Jamart J. Lifids in ischaemic stroke subtypes. Acta Neurol Belg. 2004 Mar;104(1):13-9.
Bownaan TS, Sesso HD, Ma J, Kurth T, Kase CS, Stamfer MJ, et al. Cholesterol and the risk of ischaemic stroke. Neurol. 1998;50:196-03.
Tanne D, Koven-Morag N, Graff E, Goldbourt U. Blood lipids and first ever ischaemice stroke/transient ischaemic attack in the Beazafibrate infarction prevention (BIP) Registry: hightriglyceride constitute an independent risk factor. Circulation. 2001 Dec 11;104(29):2892-7.
Shahar E, Chambless LE, Rosmond WD, Bolan LL, Ballnating CM, Mc Corern PG, et al. Plasma lipid profile and incident of ischaemic stroke: the atherosclerosis risk in communities (ARIC) study. Storke. 1989;20:983-9.
Charles W. Stroke, transient ischaemic attacks and venous thrombosis. In: Donaghy M. Brain’s disease of the nervous system. 11th ed. New York: Oxford University Press Inc; 2001;776-780.