Clinical Edge

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FH and High LDL-C in Risk of Ischemic Stroke

Circulation; ePub 2018 Mar 28; Beheshti, et al

Familial hypercholesterolemia (FH) and high concentrations of low-density lipoprotein cholesterol (LDL-C) did not confer an increased risk of ischemic stroke, a recent study found. The associations of FH and high LDL-C with ischemic stroke risk were tested in causal, genetic, and observational analyses using 106,412 individuals from the Copenhagen General Population Study (CGPS) and/or 10,372 individuals from the Copenhagen City heart study (CCHS). Researchers found:

  • The cumulative incidences in individuals in the CGPS with and without FH causative mutations were similar for ischemic stroke, but not for myocardial infarction (MI); results were similar in the CCHS.
  • There was no association between clinical FH and ischemic stroke, expect if personal premature ischemic heart disease was included in the clinical FH criteria.
  • Ischemic heart disease at baseline was associated with higher ischemic stroke risk.
  • For a 1 mmol/L higher LDL-C, the genetic causal risk ratio was 1.11 for ischemic stroke and 1.45 for MI.


Beheshti S, Madsen CM, Varbo A, Benn M, Nordestgaard BG. Relationship of familial hypercholesterolemia and high LDL cholesterol to ischemic stroke: The Copenhagen General Population Study. [Published online ahead of print March 28, 2018]. Circulation. doi:10.1161/CIRCULATIONAHA.118.033470.

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