In Chinese Adults, Causal Associations of Blood Lipids and the Risk of Ischaemic Stroke and Intracerebral Hemorrhage

Li Xiu*

The second leading cause of death worldwide is stroke, which accounts for more than 6 million deaths annually, including 2 million stroke deaths in China. Despite the fact that the incidence of Ischaemic Stroke (IS) is approximately four times higher than that of haemorrhagic stroke (mainly Intracerebral Haemorrhage (ICH)), both haemorrhagic stroke and IS account for the same number of stroke deaths in China. Despite having a lower mean level of Low Density Lipoprotein Cholesterol (LDL-C), China also has a higher rate of ICH and a higher incidence of stroke when compared to western populations. LDL-C lowering trials showed similar risk reductions for IS and CHD8–10, whereas observational studies reported weaker positive associations of LDL-C with IS than with Coronary Heart Disease (CHD). Conflicting results 11–13 from Mendelian Randomisation (MR) studies of LDL-C and IS have raised concerns regarding the significance of LDL-C for IS. Statins may not have been used as widely to prevent Cardiovascular Disease (CVD) in China because of concerns about the increased risks of ICH associated with lowering LDL-C. In a nested case control study in the China Kadoorie Biobank (CKB), we compared the risks for both stroke types associated with equivalent differences in LDL-C in MR analyses and with worldwide LDL-C lowering trials, as well as the associations of biochemically measured LDL-C and other major lipids with IS and ICH. The outcomes showed solid positive relationship of LDL-C with IS and similarly solid backwards relationship with ICH, that were affirmed by hereditary examinations and by LDL-C bringing down preliminaries, however bringing down LDL-C is still liable to have net advantage for avoidance of generally stroke and CVD in Jawline.