Researchers suggest prevention guidelines should go beyond cholesterol recommendations.

Increasing levels of nonfasting triglycerides are associated with a higher risk of ischemic stroke, according to researchers from Copenhagen University Hospital. The study compared the risk of stroke related to very high levels of nonfasting triglycerides with high cholesterol levels.

“Interestingly, current guidelines on stroke prevention have recommendations on desirable cholesterol levels but not on nonfasting triglycerides,” notes lead study author Marianne Benn, M.D., Ph.D., from Copenhagen University Hospital. “Our findings suggest that levels of nonfasting triglycerides should be included in stroke prevention guidelines, which currently focus on total cholesterol and LDL cholesterol levels.”

Details of the paper titled “Non-fasting Triglycerides, Cholesterol and Stroke in the General Population” appear in the Annals of Neurology.

Medical evidence suggests that elevated nonfasting triglycerides are markers of elevated levels of lipoprotein remnants, particles similar to LDL that are thought to contribute to plaque build-up. The Danish team followed 7,579 women and 6,372 men who were enrolled in the Copenhagen City Heart Study, all of whom were Caucasian and of Danish decent.

Participants had nonfasting triglycerides and cholesterol measurements taken at baseline (1976–1978) and were followed for up to 33 years. A diagnosis of ischemic stroke was made when focal neurological symptoms lasted more than 24 hours. During the follow-up period, completed by 100% of participants, 837 women and 837 men developed ischemic stroke.

Results confirmed stepwise increasing levels of nonfasting triglycerides associated with increased risk of ischemic stroke in both women and men. In women, triglycerides levels of 1–2 mmol/L (89–177 mg/dL) carried a relative risk of 1.2 and levels of 5 mmol/L (443 mg/dL) or greater were associated with a 3.9-fold greater risk compared with women whose triglycerides levels were less than 1 mmol/L (89 mg/dL). At similar triglyceride levels men had a relative risk that ranged from 1.2 to 2.3.

Increasing cholesterol levels did not associate with greater risk of ischemic stroke, except in men whose cholesterol levels were equal to 9 mmol/L (348 mg/dL) or more (relative risk of 4.4).

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