HDL Cholesterol and Stroke Risk: The Multi-Ethnic Study of Atherosclerosis

Research shows a link between HDL cholesterol and cardiovascular disease. Evidence of the relationship between HDL cholesterol and stroke risk is mixed. Accurate identification of risk factors for stroke is important for public health promotion and disease prevention. Whether measurement of HDL cholesterol content, particle number, or size is a better indicator of stroke risk remains disputed. Furthermore, the degree to which ethnicity is implicated in the emergence of these risk factors is unknown. The current study examined the relationship among HDL cholesterol, particle number, particle size, and ethnicity in predicting stroke. The population was an ethnically diverse cohort of US men and women between the ages of 45 - 84 years enrolled in 2000 - 2002 and followed up through December 2011 in the Multi-Ethnic Study of Atherosclerosis (MESA). Results indicated that HDL-C and number of large HDL particles were negatively associated with stroke outcome. When interactions with race were evaluated, the relationship between both HDL variables and stroke outcome emerged as significant in Blacks, but not other races. We conclude that HDL-C is a reliable measure of stroke outcome, and the potentially protective role of large HDL particles calls for replication in future samples. Furthermore, the relationship between HDL subfractions and race/ethnicity warrants further study