A cross-sectional study of impact of dyslipidemia in stroke

Niranjan Ganesh Kanagarajan, Reema Ningthoukhongjam, Robinson Ningshen, Thangjam G. Singh, Vikie Khruomo


Background: Stroke is defined as abrupt onset of symptoms and/or sign of focal and global loss of cerebral function lasting for at least 24 hrs with no apparent cause other than of vascular origin. Dyslipidemia in stroke is not widely studied especially from the population of Northeast India (Manipur). Moreover, most prior studies did not specifically compare hemorrhagic stroke risk among those with elevated lipid levels to those with optimal or near optimal lipid levels. Therefore, we studied the levels of different Lipids in stroke patients (hemorrhagic and ischemic) to understand its role in pathogenesis of stroke.  

Methods: This cross-sectional study was conducted in RIMS, Manipur from 2017-2019 and included 185 patients above 18 years with stroke within 48 hrs of onset of symptoms. NCCT brain and serum lipids, other related blood investigations were performed.

Results: We found that serum total cholesterol, LDL-C and triglycerides are significantly higher in infarction patients with average levels of 210.82 mg/dl, 143.64 mg/dl and 151.50 mg/dl respectively which is statistically significant (p<0.001). The average serum total cholesterol, LDL-C and triglycerides are significantly lower in ICH patients with average levels of 143.34 mg/dl, 84.67 mg/dl and 113.94 mg/dl respectively which is statistically significant. (p<0.001).

Conclusions: We concluded that raised level of serum total cholesterol, serum LDL-C, serum triglyceride are associated with cerebral infraction (p=0.001) and lower level of serum total cholesterol, serum LDL-C, serum triglyceride are associated with cerebral hemorrhage (p=0.001). Thus, serum lipid levels should be carefully monitored to prevent life threatening stroke.


Cerebro vascular accidents, Hemorrhage, Infarction, Lipid profile, Stroke

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Young AR, Ali C, Duretête A, Vivien D. Neuroprotection and stroke: Time for a compromise. J Neurochem. 2007;103(4):1302–9.

Argade DS, Shendye DRJ. Study of serum high sensitivity C- reactive protein and lipid profile in ischemic and hemorrhagic stroke. Int J Clin Biomed Res. 2019;42–5.

Kamalakannan S, Gudlavalleti ASV, Gudlavalleti VSM, Goenka S, Kuper H. Incidence & prevalence of stroke in India: A systematic review. Ind J Med Res. 2017;146(2):175-185.

Smith NM, Pathansali R, Bath PMW. Vascular Medicine. 1999;25(2):50-5

Pikula A, Beiser AS, Wang J, Himali JJ, Kelly-Hayes M, Kase CS, et al. Lipid and lipoprotein measurements and the risk of ischemic vascular events: Framingham Study. Neurol. 2015;84(5): 472–9.

Yaghi S, Elkind MSV. Lipids and Cerebrovascular Disease: Research and Practice. Strok. 2015;46(11): 3322–8.

Rist PM, Buring JE, Ridker PM, Kase CS, Kurth T, Rexrode KM. Lipid levels and the risk of hemorrhagic stroke among women. Neurol. 2019; 92(19):e2286–94.

Pandian JD, Sudhan P. Stroke Epidemiology and Stroke Care Services in India. J Strok. 2013; 15(3):128.

National Cholesterol Education Program High Blood Cholesterol ATP III Guidelines. Available at Accessed on 20 May 2020.

Ma C, Gurol ME, Huang Z, Lichtenstein AH, Wang X, Wang Y, et al. Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage. Neurol. 2019;93(5):e445–57.

Labreuche J, Deplanque D, Touboul PJ, Bruckert E, Amarenco P. Association between change in plasma triglyceride levels and risk of stroke and carotid atherosclerosis: systematic review and metaregression analysis. Atherosclerosis. 2010;212: 9–15.

Iso H, Jacobs DR Jr, Wentworth D, Neaton JD, Cohen JD. Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial. N Engl J Med. 1989;320:904–910.

1Bonaventure A, Kurth T, Pico F, Barberger-Gateau P, Ritchie K, Stapf C, et al. Triglycerides and risk of hemorrhagic stroke vs. ischemic vascular events: The Three-City Study. Atherosclero. 2010;210: 243–8.

Amarenco P, Labreuche J, Touboul PJ. High-density lipoproteincholesterol and risk of stroke and carotid atherosclerosis: a systematic review. Atherosclero. 2008;196:489–96.

Chei CL, Yamagishi K, Kitamura A, Kiyama M, Imano H, Ohira T, et al; CIRCS Investigators. High-density lipoprotein subclasses and risk of stroke and its subtypes in Japanese population: the Circulatory Risk in Communities Study. Stroke. 2013;44: 327–33.

Menet R, Bernard M, ElAli A. Hyperlipidemia in Stroke Pathobiology and Therapy: Insights and Perspectives. Front Physiol. 2018;9:488.

Tirschwell DL, Smith NL, Heckbert SR, Lemaitre RN, Longstreth WT Jr, Psaty BM. Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups. Neurol. 2004;63:1868–75.

Amarenco P, Labreuche J, Elbaz A, Touboul PJ, Driss F, Jaillard A, et al; GENIC Investigators. Blood lipids in brain infarction subtypes. Cerebrovasc Dis. 2006;22:101–8.

Cui R, Iso H, Yamagishi K, Saito I, Kokubo Y, Inoue M, et al; JPHC Study Group. High serum total cholesterol levels is a risk factor of ischemic stroke for general Japanese population: the JPHC study. Atherosclerosis. 2012;221:565–9.

Imamura T, Doi Y, Arima H, Yonemoto K, Hata J, Kubo M, et al. LDL cholesterol and the development of stroke subtypes and coronary heart disease in a general Japanese population: the Hisayama study. Strok. 2009;40:382–8.

Longstreth WT Jr, Arnold AM, Beauchamp NJ Jr, Manolio TA, Lefkowitz D, Jungreis C, et al. Incidence, manifestations, and predictors of worsening white matter on serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study. Strok. 2005;36:56–61.

Jimenez-Conde J, Biffi A, Rahman R, Kanakis A, Butler C, Sonni S, et al. Hyperlipidemia and reduced white matter hyperintensity volume in patients with ischemic stroke. Strok. 2010;41: 437–42.

Vernooij MW, van der Lugt A, Ikram MA, Wielopolski PA, Niessen WJ, Hofman A, et al. Prevalence and risk factors of cerebral microbleeds: the Rotterdam Scan Study. Neurology. 2008;70: 1208–14.