Serum lipids in young patients with ischaemic stroke: a case-control study

Objectives-The relation between serum lipids and ischaemic stroke remains c ontroversial. Studies of lipid related risk factors in cerebrovascular dise ase have varied greatly in their findings and also in their definition of t he cerebrovascular end points. Serum lipids are thought to interact with th e pathogenesis of stroke through an atherosclerosis mechanism. Stroke in yo ung patients have been shown to be related to non-atherosclerotic causes mo st of the time. The aim was to determine the serum lipid profile and the va scular risk factors for ischaemic stroke in a series of patients under 45 w ith an ischaemic stroke and to compare them with a series of controls of th e same age. Methods-Ninety four consecutive patients with ischaemic stroke were compare d with 111 controls of the same age recruited from a regional electoral lis t. Vascular risk factors were recorded and serum lipid profile was determin ed in all of them. Results-Multivariate analyses showed that low HDL cholesterol, male sex, sm oking, hypertension, and oral contraceptives were risk factors for intracer ebral arterial occlusion. Conclusion-Low HDL cholesterol was the only serum lipid index to be associa ted to an increased risk of stroke in this population. Low HDL cholesterol must be considered in the care management of young patients regardless of t he detectable presence of atherosclerosis.