Explore The Association Between Low Density Lipoprotein Cholesterol Level And The Risk Of Hemorrhagic Stroke

Objective This study aims to explore the association between low density lipoprotein cholesterol(LDL-C)level and the risk of hemorrhagic stroke,and analyze the relationship between LDL-C level and the risk of hemorrhagic stroke at different blood pressure levels.To provide a scientific basis for implementing strategies to safely reduce LDL-C levels to prevent atherosclerotic cardiovascular disease(ASCVD).Methods This study is based on the project initiated by Inner Mongolia Autonomous Region Health Commission in 2017 to explore the relationship between low density lipoprotein cholesterol and blood pressure and the risk of hemorrhagic stroke Project,a case-control study was adopted.The subjects were all hospitalized or physical examination patients from June 2020 to February 2021 in a Class A hospital.Patients with hemorrhagic stroke were selected as the case group,while those without stroke during the same period were selected as the control group Standardized questionnaires were used to collect demographic information and related medical history of subjects in the two groups,and differences in classified data were compared by test.Binary multivariate Logistic regression was used to adjust related factors,and the risk of hemorrhagic stroke with different levels of LDL-C was analyzed Excel software was used to establish a database for all data,and SPSS25.0 was used for statistical analysis.Results The univariate analysis results of influencing the incidence of hemorrhagic stroke showed that the age and residence of hypertension and abnormal glucose metabolism LDL-C level group were related to the risk of hemorrhagic stroke,and the difference was statistically significant(P<0.05).The results of multivariate Logistic regression analysis on the incidence of hemorrhagic stroke showed that the risk of hemorrhagic stroke in people aged 40-50 years was 8.521 times that in people aged <40 years(OR =8.521,95% CI:2.852–25.456).The risk of hemorrhagic stroke in hypertensive subjects was 2.474 times that in non-hypertensive subjects(OR=2.474,95% CI:1.230–4.977).The risk of hemorrhagic stroke varies with different LDL-C levels,with the risk of LDL-C < 70mg/ d L,100-130 mg/ d L,or ≥130 mg/d L being 4.002,3.210,and7.57,respectively,compared with LDL-C=70-100 mg/ d L.Rural population had a 0.138(OR =0.138,95% CI:0.044 – 0.427)risk of hemorrhagic stroke compared with urban population,and rural residence was a protective factor for hemorrhagic stroke.In the population with SBP≥130mm Hg,there was a statistically significant difference in the prevalence of hemorrhagic stroke among different LDL-C groups(P=0.017< 0.05).Further,through multivariate analysis,the OR values of LDL-C<70mg/ d L,100-130 mg/d L and≥130 mg/d L were 4.500,3.000 and 4.952,respectively,relative to LDL-C=70-100mg/d L.No increased risk of hemorrhagic stroke with LDL-C<70mg/d L was found in those with systolic blood pressure <130mm Hg.Conclusion Different LDL-C levels have different risk of hemorrhagic stroke.Both high LDL-C levels(≥130mg/ d L)and low LDL-C levels(<70mg/ d L)increase the risk of hemorrhagic stroke,that is,with the increase of LDL-C levels,the risk of hemorrhagic stroke presents a "U" type change.The risk of hemorrhagic stroke was significantly increased with lower or higher LDL-C levels,especially with higher systolic blood pressure(≥130mm Hg).At lower levels of systolic blood pressure(<130mm Hg),the risk of hemorrhagic stroke was increased only when LDL-C levels were higher.This study provides relevant basis for the formulation of strategies to safely reduce LDL-C levels to prevent and control ASCVD.