What is the relationship between cholesterol levels and risk of stroke in the general population?
Epidemiological studies suggest that there is a competing stroke risk related to total cholesterol levels in the general population. In most studies, there is an inverse relationship between cholesterol levels and risk of hemorrhagic stroke. In contrast, high levels of total cholesterol have been associated with an increased risk of ischemic stroke. The risk of death resulting from intracranial hemorrhage (ICH) was found to be increased 3-fold in men with total cholesterol concentrations <4.14 mmol/L (160 mg/dL) compared with higher levels. In a pooled cohort analysis, lower levels of LDL cholesterol were inversely associated with incident intracranial hemorrhage. In a Japanese nested case-control study, patients with intraparenchymal hemorrhage had lower cholesterol levels than control subjects. However, in a Korean Medical Insurance Corporation Study of 115 000 men, low serum cholesterol was not an independent risk factor for ICH.