Higher Total Serum Cholesterol Levels Are Associated With Less Severe Strokes and Lower All-Cause Mortality. Ten-Year Follow-Up of Ischemic Strokes in the Copenhagen Stroke Study.

Olsen TS, Christensen RH, Kammersgaard LP, Andersen KK.
From the Stroke Unit, Hvidovre University Hospital, Hvidovre, and the Department of Informatics and Mathematical Modeling, Section for Statistics, Technical University of Denmark, Lyngby, Denmark.

BACKGROUND AND PURPOSE:
Evidence of a causal relation between serum cholesterol and stroke is inconsistent. We investigated the relation between total serum cholesterol and both stroke severity and post stroke mortality to test the hypothesis that hypercholesterolemia is primarily associated with minor stroke.

METHODS: In the study, 652 unselected patients with ischemic stroke arrived at the hospital within 24 hours of stroke onset. A measure of total serum cholesterol was obtained in 513 (79%) within the 24-hour time window. Stroke severity was measured with the Scandinavian Stroke Scale (0=worst, 58=best); a full cardiovascular risk profile was established for all. Death within 10 years after stroke onset was obtained from the Danish Registry of Persons.

RESULTS: Mean+/-SD age of the 513 patients was 75+/-10 years, 54% were women, and the mean+/-SD Scandinavian Stroke Scale score was 39+/-17. Serum cholesterol was inversely and almost linearly related to stroke severity: an increase of 1 mmol/L in total serum cholesterol resulted in an increase in the Scandinavian Stroke Scale score of 1.32 (95% CI, 0.28 to 2.36, P=0.013), meaning that higher cholesterol levels are associated with less severe strokes. A survival analysis revealed an inverse linear relation between serum cholesterol and mortality, meaning that an increase of 1 mmol/L in cholesterol results in a hazard ratio of 0.89 (95% CI, 0.82 to 0.97, P=0.01).

CONCLUSIONS: The results of our study support the hypothesis that a higher cholesterol level favors development of minor strokes. Because of selection, therefore, major strokes are more often seen in patients with lower cholesterol levels. Post stroke mortality, therefore, is inversely related to cholesterol.


Comment by Joan Baumann

Dr. Ladd McNamara has shared so much valuable information on the subject of cholesterol and statin use.  Adding just a little bit more to the fine article sent out on this forum earlier is research which was in The August 30th, 2007 edition the Journal Stroke. 

It is so ironic that a follow up of 652 stroke patients revealed that those with the lowest levels of cholesterol were more likely to die than those with higher levels!

To think that lower cholesterol levels are actually found in patients who experience major strokes vs. higher levels in patients with minor strokes.

I sent the research to Dr. McNamara who has posted it on his website and he included the following comment:

Dr. McNamara: What this says is, the lower the cholesterol in this study the more potentially fatal the stroke. The people with higher cholesterol levels had less severe strokes than the people with low cholesterol levels.

Dr. Wentz has written a wonderful forward in Dr. McNamara's latest edition of the Cholesterol Conspiracy which you can read: http://cholesterolconspiracy.blogspot.com/

It is a true scientist's explanation of the beneficial role of cholesterol.

Let's help spread the message of stroke prevention by adopting a healthy lifestyle and using supplements that prevent LDL oxidation; Antioxidants!  The Essentials and HealthPak are loaded with the best quality antioxidants available.