Muhammad Nazim Khan, Hina Dilruba Khan, Masood Ahmad, Muhammad Umar.
Serum Total and HDL-Cholesterol in Ischemic and Hemorrhagic Stroke.
Ann Pak Inst Med Sci Jan ;10(1):22-6.

Objective: To determine frequency of dyslipidemia (hypercholesterolemia or low HDLCholesterol) among strokes patients and compare frequency of dyslipidemia between ischemic and hemorrhagic strokes patients. Study design: Descriptive case series Setting and Duration of Study: Department of Medicine, Holy Family Hospital, Rawalpindi, from Jan. 2013 to Dec. 2013. Materials and Methods: 370 consecutive patients of stroke, both males and females, above 18 years of age were included in the study. Patients on lipid lowering therapy were excluded. Informed consent was obtained and data was collected on a written proforma. Serum samples for total cholesterol and HDL-C were obtained on the morning after overnight fast and CT scan brain was performed. Results: Based on Brain CT scan findings, 370 patients (229 females and 141 males) were divided into two groups, Ischemic stroke (190) and Hemorrhagic stroke (180). Mean age (yrs) of stroke patients was 58.1+15. Mean total cholesterol level (mg/dl) was 173.8+66.7, whereas mean HDL-cholesterol level was 40.0+13.2. Out of 370 patients, 88 (23.7%) patients presented with hypercholesterolemia (serum TC > 200 mg/dl) in which frequency of hypercholesterolemia was significantly higher (p-value 0.009) in patients with Ischemic stroke as compared to hemorrhagic stroke (29.4% Vs 17.8%). Similarly, out of 370 patients, 136 (36.7%) patients presented with reduced HDL-C levels (serum HDL-C < 35 mg/dl). Ischemic stroke patients had significantly more frequency (pvalue 0.005) of reduced HDL-C than hemorrhagic stroke patients (43.7% Vs 29.4%). Out of 370 patients, 18 (4.9%) patients had both hypercholesterolemia and low HDL. Frequencies for other modifiable risk factors were 74.6% with hypertension, 28.3% with IHD, 20.5% diabetic and 17.8% cigarette smokers. Conclusions: Ischemic stroke patients had significantly higher frequency of hypercholesterolemia and reduced HDL-Cholesterol levels than patients of hemorrhagic stroke. Screening dyslipidemia for high risk patients for stroke and lipid lowering therapy are recommended as preventive measures.

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