Isolated low levels of high‐density lipoprotein cholesterol and stroke incidence: JMS Cohort Study

BACKGROUND: The cardiovascular relevance of isolated low levels of high‐density lipoprotein cholesterol (HDL‐C) is yet to be determined. Stroke often leads to long‐term disability, and thus, not only stroke mortality but also stroke incidence is a topic of research. Although isolated low HDL‐C level has been found to be a predictor for stroke mortality previously, whether it can predict stroke incidence is unknown. METHODS: In the Jichi Medical School cohort study, 11 025 community‐living residents without a history of stroke were examined. Hazard ratios (HRs) for isolated and non‐isolated low HDL‐C levels were calculated relative to those for normal HDL‐C levels in stroke patients using Cox's regression models. RESULTS: During the mean follow‐up period of 10.7 years, 412 residents had their first‐ever stroke. The multivariable‐adjusted HRs for the levels of isolated and non‐isolated low HDL‐C were 1.11 (95% confidence interval, 0.85‐1.44) and 1.35 (1.01‐1.81), respectively, when compared to that for normal HDL‐C. CONCLUSION: Low HDL‐C levels with other dyslipidemias may contribute to the incidence of stroke, not isolated low HDL‐C.