Low serum cholesterol and haemorrhagic stroke in men: Korea Medical Insurance Corporation Study

Background In some prospective studies. haemorrhagic stroke occurs more fre quently in individuals with low serum cholesterol than in those with higher concentrations. We aimed to determine whether low total serum cholesterol is an independent risk factor for haemorrhagic stroke (intracerebral haemor rhage and subarachnoid haemorrhage) in South Korea. a country that has a po pulation with relatively low concentrations of total serum cholesterol. Methods We measured total serum cholesterol and other cardiovascular risk f actors in 114793 Korean men, aged between 35-59 years in 1990 and 1992, in a prospective observational study. We used data obtained in 1992 for smokin g and alcohol consumption. We divided total serum cholesterol into quintile s (<4.31 mmol/L, 4.31-<4.74, 4.74-<5.16, 5.16-<5.69 and greater than or equ al to5.69). Our primary outcomes were hospital admissions and deaths from i ntracerebral and subarachnoid haemorrhage in a 6 year follow-up between 199 3 and 1998. Findings 528 men had a haemorrhagic stroke-372 intracerebral and 98 subarac hnoid haemorrhage-and 58 were unspecified strokes. The relative risks of in tracerebral haemorrhage in each quintile of total serum cholesterol (lowest to highest were: 1.22 (95% CI 0.88-1.69); 0.86 (0.60-1.21); 1.08 (0.78-1.4 8): and 1.03 (0.75-1.41). The corresponding relative risks for subarachnoid haemorrhage were: 1.44 (0.76-2.73); 1.13 (0.59-2.20): 1.21 (0.64-2.29): an d 1.12 (0.59-2.14). Interpretation Low total serum cholesterol Is not independent risk factor f or either intracerebral subarachnoid haemorrhagic stroke in Korean men.