Details

Autor(en) / Beteiligte

• Saito, Isao
• Yamagishi, Kazumasa
• Kokubo, Yoshihiro
• Yatsuya, Hiroshi
• Iso, Hiroyasu
• Sawada, Norie
• Inoue, Manami
• Tsugane, Shoichiro

Titel

Non-High-Density Lipoprotein Cholesterol and Risk of Stroke Subtypes and Coronary Heart Disease: The Japan Public Health Center-Based Prospective (JPHC) Study

Ist Teil von

• Journal of Atherosclerosis and Thrombosis, 2020/04/01, Vol.27(4), pp.363-374

Ort / Verlag

Japan: Japan Atherosclerosis Society

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Aim: A positive association between non-high-density lipoprotein cholesterol (non-HDL-C) and coronary heart disease (CHD) has been established; however, associations between non-HDL-C and stroke subtypes have not been determined. Methods: We conducted a prospective study of 30,554 individuals aged 40–69 yrs with no history of cardiovascular disease (CVD) in Japan. Sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of stroke subtypes and CHD were estimated according to quintiles of non-HDL-C, using Cox proportional hazard models adjusted for other established risk factors. Results: We identified 1,705 stroke and 296 CHD events over a median 15 yrs of follow-up. The fractional polynomials analysis revealed a U-shaped association between non-HDL-C and stroke risk in men. When analyzed for stroke subtypes, the data revealed an inverse relationship between non-HDL-C and intracerebral hemorrhage (ICH), primarily with lobar ICH, and a positive association between non-HDL-C and large-artery occlusive infarction in men [adjusted HR 0.55 (95% CI, 0.35–0.87) and 2.05 (95% CI, 1.07–3.93) for the highest and lowest quintile of non-HDL-C, respectively]. The lowest risk of ICH in women was observed in the fourth quintile, and the lowest risk of embolic infarction was observed in the third quintile. In contrast, non-HDL-C was positively associated with CHD in both sexes. Conclusions: In Japanese men, lower non-HDL-C levels were associated with a decreased risk of large-artery occlusive infarction and an increased risk of ICH, particularly lobar ICH.