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Combined Association of Low-Density Lipoprotein Cholesterol Levels and Systolic Blood Pressure to the Outcome of Intracerebral Hemorrhage: Data from the China Stroke Center Alliance



. 2022 Jun 18;2022:6206315.


doi: 10.1155/2022/6206315.


eCollection 2022.

Affiliations

Item in Clipboard

Yarong Ding et al.


Oxid Med Cell Longev.


.

Abstract

Limited data were available about the combined impact of systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) levels on intracerebral hemorrhage (ICH) prognosis. The objective of this study is to explore whether the relationship between LDL-C and ICH outcomes was modified by SBP levels in a Chinese population. From August 1, 2015, to July 31, 2019, 75,443 ICH patients enrolled from the Chinese Stroke Center Alliance program were included in our study. Patients were divided into LDL-C levels of <70 mg/dL, 70-100 mg/dL, and ≥100 mmol/L. SBP was stratified as <140 mmHg, 140-180 mmHg, and ≥180 mmHg. The primary outcome was the occurrence of hematoma expansion (HE), and the second outcome was in-hospital mortality. Correlation between LDL-C levels and SBP on ICH outcomes were assessed by logistic regression. 6,116 (8.1%) and 1,576 (2.1%) patients suffered HE and in-hospital mortality. Compared with the ≥100 mg/dL group, patients with LDL-C concentrations under 70 mg/dL had a 19% and 24% increase in the relative risk of HE (crude OR 1.19, 95% CI 1.11-1.28) and in-hospital mortality (crude OR 1.24, 95% CI 1.08-1.42). When SBP was added as a stratification variable, the above-mentioned association was attenuated in patients under a threshold SBP of 140 mmHg (P > 0.05). However, no statistical interaction was detected between SBP and LDL-C levels. Lower LDL-C levels (<70 mg/dL) are related to a higher risk of HE and in-hospital mortality confined to ICH patients with elevated SBP (≥140 mmHg).

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures



Figure 1

Flow chart for selection of study participants. TIA: transit ischemic attack; CSCA: Chinese Stroke Center Alliance; LDL-C: low-density lipoprotein cholesterol; SBP: systolic blood pressure; ICH: intracerebral hemorrhage.


Figure 2


Figure 2

Prevalence of (a) hematoma expansion and (b) in-hospital mortality according to LDL-C levels across systolic blood pressure subgroups. LDL-C: low-density lipoprotein cholesterol.


Figure 3


Figure 3

Association of LDL-C with HE or in-hospital mortality across SBP categories among patients admitted within 24 h of symptom onset. LDL-C: low-density lipoprotein cholesterol; HE: hematoma expansion; SBP: systolic blood pressure. P = 0.747 for HE; P = 0.604 for in-hospital mortality. 60,024 (79.6%) patients were admitted within 24 h of symptom onset.

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