High-Density Lipoprotein Cholesterol and Ischemic Stroke in the Elderly

Abstract

TROKE IS A MAJOR CAUSE OF death and disability in the United States and is a growing public health concern. The latest projections estimate that more than 1 million strokes will occur every year by the year 2010. Moreover, stroke has a disproportionate impact on elderly, black, and Hispanic persons, who are among the fastest growing segments of the US population. Many studies have provided strong evidence for lipids as a risk factor for coronary artery disease (CAD). These studies demonstrate a direct relationship between total cholesterol, low-density lipoprotein cholesterol (LDL-C), and CAD and an inverse relationship between highdensity lipoprotein cholesterol (HDL-C) and CAD. 1-4 These relationships have not been as clearly established for ischemic stroke with some studies even questioning whether cholesterol is a risk factor for stroke. The advent of statin agents, which significantly lower lipid levels by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, has focused more research on lipids in all vascular outcomes, in particular stroke. Compelling data from statin trials show impressive reductions in stroke risk among persons with CAD. 5 Some researchers have suggested that the

Heritabilities of the metabolic syndrome and its components in the Northern Manhattan Family Study

“…NOMAFS is a cohort of high-risk Caribbean-Hispanic probands and their family members initially identified from the Northern Manhattan Study (NOMAS) stroke-free cohort [27]. A high-risk proband was defined by one of the following criteria: (1) reporting a sibling with a history of myocardial infarction or stroke; (2) having two of three quantitative risk phenotypes (maximal carotid plaque thickness, left ventricle mass divided by the body surface area, or homocysteine level) above the 75th percentile in the NOMAS cohort.…”

A Ten Year Overview of Surgical and Interventional Arrhythmology in Russia. Service Peculiar Features in the Far East

“…Крупные исследования со статинами показали значительное снижение частоты развития инсульта у пациентов с ИБС или с высоким риском за счет снижения частоты развития ишемиче-ского инсульта [469] . Повышенные концентрации три-глицеридов и низкие уровни ХС-ЛПВП также связаны с негеморрагическим инсультом [490,491] . Именно поэтому пациенты с ишемическим цереброваскуляр-ным заболеванием заслуживают таково же внимания к медикаментозному контролю липидов крови, как и больные ИБС .…”

High-Density Lipoproteins in Stroke

“…Based on the observation that low HDL cholesterol levels were associated with cerebrovascular events (Sacco et al 2001;Wannamethee et al 2000), Paterno et al showed that pretreatment with reconstituted HDL reduced neuronal damage in two experimental models of stroke in rats (Paterno et al 2004). They showed that high doses of rHDLs (120 mg/kg) infused 2 h before the onset of stroke reduced the brain necrotic area by 61 and 76 %, respectively, in an excitotoxic (NMDA) and a transient MCAO model of stroke in rats.…”