Gender differences in blood lipids and the risk of ischemic stroke among the hypertensive adults in rural China

Abstract

Background: Though large epidemiological studies have not established\nassociations between blood lipids and ischemic stroke, increasing\nevidences have suggested that lipid-modifying agents may reduce\ncerebrovascular events. Aims: To determine whether blood lipids are\nrisk factors for ischemic stroke among hypertensive rural adults in\nChina.\tSettings and Design: A cross-sectional survey was conducted\nduring 2004-2006, which underwent cluster multistage sampling to a\nhypertensive resident group in the countryside of China. Materials and\nMethods: A total of 6,412 individuals (2,805 men, 3,607 women) with\nage ≥ 35 years were included. At baseline, lifestyle and other\nfactors were obtained and blood lipids were assessed at a central study\nlaboratory. Ischemic stroke was defined according to the criteria\nestablished by the National Survey of Stroke and all cases were further\nclassified into lacunar infarction and other ischemic strokes. \nStatistical Analysis: Univariable and multivariable logistic\nregression were used. Results: In the univariable logistic regression\nmodel, LDL cholesterol (LDLc) in men and total cholesterol (TC), LDLc\nand TC-to-HDL cholesterol (TC: HDLc ratio) in women were risk factors\nfor other ischemic strokes, with OR 1.42 (95% CI , 1.16-1.75), 1.31\n(95% CI , 1.11-1.55), 1.47 (95% CI , 1.16-1.88) and 1.67 (95% CI ,\n1.28-2.14), respectively. After adjusting for independent variables, an\nincrease in non-HDL cholesterol (non-HDLc) was associated with a\nsignificant increased risk of other ischemic strokes in women, with\nadjusted OR 1.45 (95% CI, 1.08-1.93). Conclusions: LDLc was the\ncommon risk factor for ischemic stroke in men and women, whereas\nNon-HDLc, TC and TC: HDLc ratio levels were related to ischemic stroke\nas risk factors only in women.