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Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myocardial infarction: Korean national health system prospective cohort study

Ebrahim, Shah ; Sung, Joohon ; Song, Yun-Mi ; Ferrer, Robert L ; Lawlor, Debbie A ; Smith, George Davey

BMJ, 2006-07, Vol.333 (7557), p.22-25 [Periódico revisado por pares]

England: British Medical Journal Publishing Group

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  • Título:
    Serum cholesterol, haemorrhagic stroke, ischaemic stroke, and myocardial infarction: Korean national health system prospective cohort study
  • Autor: Ebrahim, Shah ; Sung, Joohon ; Song, Yun-Mi ; Ferrer, Robert L ; Lawlor, Debbie A ; Smith, George Davey
  • Assuntos: Adult ; Alcohol drinking ; Alcohol Drinking - mortality ; Alcohols ; Blood ; Cholesterol - blood ; Cholesterols ; Epidemiologic Methods ; Female ; gamma-Glutamyltransferase - blood ; Humans ; Hypertension ; Hypertension - mortality ; Korea - epidemiology ; Male ; Men ; Middle Aged ; Myocardial infarction ; Myocardial Infarction - blood ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Predisposing factors ; Serum cholesterol ; Stroke - blood ; Stroke - etiology ; Stroke - mortality ; Strokes
  • É parte de: BMJ, 2006-07, Vol.333 (7557), p.22-25
  • Notas: ark:/67375/NVC-LKWZ9XDV-4
    href:bmj-333-22.pdf
    local:bmj;333/7557/22
    PMID:16757495
    Correspondence to: J Sung, Department of Preventive Medicine, Kangwon National University College of Medicine, Hyoja-2-Dong, Chunchon, Kangwon-Do, Korea
    ArticleID:bmj.38855.610324.80
    istex:0B1C5B4C5A80DC908093B4829652545C394CCD06
    ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
    Funding: Ministry of Health and Welfare Korea (01-PJ1-PG1-01CH10-0007) and MH63749 from the National Institutes of Mental Health. DAL is funded by a UK Department of Health career scientist award.
    Contributors: SE wrote the first draft of the paper and helped design, interpret, and revise the manuscript. JS and Y-MS had full access to the cohort data and are responsible for the integrity of data and accuracy of data analysis. JS helped design, interpret, and revise the manuscript and handle data. Y-MS helped design, analyse, and interpret the manuscript. RF helped interpret the results. DAL and GDS helped design the study and interpret the results. All authors commented on drafts and decided to submit for publication. JS and SE are guarantors.
    Correspondence to: J Sung, Department of Preventive Medicine, Kangwon National University College of Medicine, Hyoja-2-Dong, Chunchon, Kangwon-Do, Korea sungjohn@kangwon.ac.kr or sungjohn@empal.com
    Ethical approval: Internal review board of Samsung Medical Centre and Korea National Health Insurance Corporation.
    Competing interests: None declared.
  • Descrição: Abstract Objective To investigate risk factors, such as heavy alcohol consumption, that might explain any increased risk of haemorrhagic stroke associated with low blood cholesterol. Design Prospective cohort study. Setting Korea. Participants 787 442 civil servants (661 700 men, 125 742 women) aged 30-64. Main outcome measures Cardiovascular risk factors were assessed at biennial health check. Data on morbidity and mortality were ascertained from 1990 to 2001 using hospital admissions and mortality surveillance systems. Results 6328 cases of ischaemic stroke (6021 men, 307 women), 3947 cases of haemorrhagic stroke (3748 men, 199 women), 3170 cases of undefined stroke (2902 men, 268 women), and 4417 cases of myocardial infarction (4305 men, 112 women) occurred. Ischaemic stroke and myocardial infarction were strongly and positively associated with blood cholesterol (hazard ratio per 1 mmol/l cholesterol 1.20 (95% confidence 1.16 to 1.24) and 1.48 (1.43 to 1.53), respectively). Haemorrhagic stroke showed an inverse association in fully adjusted models (0.91, 0.87 to 0.95). This inverse association was confined to participants with hypertension. When stratified by concentration of γ glutamyl transferase (GGT), an indicator of alcohol consumption, the association was not seen in participants with low concentrations of GGT, and it was independent of hypertension in those with high concentrations of GGT (> 80 U/l). Conclusion High alcohol consumption may underlie the association between low blood cholesterol and increased risk of haemorrhagic stroke.
  • Editor: England: British Medical Journal Publishing Group
  • Idioma: Inglês
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