Evidence implicates
lipid abnormalities as important but modifiable risk factors for
stroke. This study assesses whether
hypercholesterolemia can be used to predict the risk for etiologic subtypes of
ischemic stroke between sexes within racial/ethnic groups. Data elements related to
stroke risk, diagnosis, and outcomes were abstracted from the medical records of 3,290
acute stroke admissions between 2006 and 2010 at a regional
stroke center. Sex comparison within racial/ethnic groups revealed that South Asian and Hispanic men had a higher proportion of
ischemic stroke than women, while the inverse was true for Whites and African Americans (P=0.0014). All women, except South Asian women, had higher mean plasma total
cholesterol and higher blood circulating
low-density lipoprotein levels (≥100 mg/dL) than men at the time of their admissions. The incidence of large-artery
atherosclerosis (LAA) was more common among women than men, except among Hispanics, where men tended to have higher incidences. A regression analysis that considered patients diagnosed with either LAA or small-artery occlusion etiologic subtype as the outcomes and
high-density lipoproteins and
triglycerides as predictors showed inconsistent associations between
lipid profiles and the incidence of these subtypes between the sexes within racial/ethnic groups. In conclusion, our investigation suggests that women
stroke patients may be at increased risk for
stroke etiologic subtype LAA than men. Although the higher prevalence of
stroke risk factors examined in this study predicts the increase in the incidence of the disease, lack of knowledge/awareness and lack of affordable treatments for
stroke risk factors among women and immigrants/non-US-born subpopulations may explain the observed associations.