[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.158.167.137. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
Letters
October 3, 2001

High-Density Lipoprotein Cholesterol and Risk of Stroke—Reply

Author Affiliations
 

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(13):1573-1574. doi:10.1001/jama.286.13.1573

In Reply: We agree that both case-control and cross-sectional studies have limitations in defining a causal association between an exposure and a disease because of the inability to accurately define the temporal relationship between the variables. In our study, we assumed that the poststroke HDL-C measurement was a proxy for prestroke HDL-C. We cited references that support the relative stability of HDL-C in acute situations.13 There is no literature that suggests that stroke will lead to a decrease in HDL-C acutely. Whether other confounding prior conditions led to a decrease in HDL-C and also increased the risk of stroke is unknown. We adjusted for multiple other risk factors and still found an independent association between HDL-C and ischemic stroke.

×