Hypercholesterolemia, HMG-CoA Reductase Inhibitors, and Risk of Intracerebral Hemorrhage

Author:

Woo Daniel1,Kissela Brett M.1,Khoury Jane C.1,Sauerbeck Laura R.1,Haverbusch Mary A.1,Szaflarski Jerzy P.1,Gebel James M.1,Pancioli Arthur M.1,Jauch Edward C.1,Schneider Alexander1,Kleindorfer Dawn1,Broderick Joseph P.1

Affiliation:

1. From the Department of Neurology and the Neuroscience Institute (D.W., B.M.K., L.R.S., M.A.H., J.P.S., A.S., D.K., J.P.B.), Department of Environmental Health (J.C.K.), and Department of Emergency Medicine (A.M.P., E.C.J.), University of Cincinnati, Ohio; Department of Neurology (J.G.), University of Louisville, Kentucky.

Abstract

Background and Purpose— Several studies have demonstrated an association between hypocholesterolemia and intracerebral hemorrhage (ICH). We tested the hypothesis that hypercholesterolemia or use of HMG-CoA reductase inhibitors (statin) agents, or both, are associated with ICH. Methods— This study was part of the preplanned midway analysis of an ongoing, population-based, case-control study of the genetic and environmental risk factors of hemorrhagic stroke. Conditional stepwise logistic regression modeling was used to determine if self-reported hypercholesterolemia or statin use, or both, were independent risk factors for ICH. Results— Between December 1, 1997, and June 30, 2000, 188 cases of ICH and 366 age-, race-, and gender-matched controls were enrolled. Hypercholesterolemia and statin use were less common among cases than controls: 25% versus 38% ( P =0.003) and 9% versus 17% ( P =0.03), respectively. Hypercholesterolemia with statin use was associated with less risk of ICH (OR=0.30; P =0.0008) in multivariable analysis after controlling for alcohol use, hypertension, previous stroke, first-degree relative with ICH, education level, and apolipoprotein E alleles. Conclusion— Hypercholesterolemia was associated with a lower risk of ICH. We have not found an increased risk of ICH with the widespread use of statins in our population. Given the lack of cholesterol levels in the current study, further studies are needed to determine if lower cholesterol levels secondary to statin use bear the same risk as low cholesterol levels for ICH.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

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