Low Density Lipoprotein Cholesterol (LDL-C) Levels and Risk for Intracerebral Hemorrhage

Low Density Lipoprotein Cholesterol (LDL-C) Levels and Risk for Intracerebral Hemorrhage

Over the years cholesterol levels have been inconsistently associated with the risk of intracerebral hemorrhage (ICH), but research findings released last week shed new light on the relationship.


ICH occurs most frequently in the basal ganglia, pons, thalamus, cerebellum, and less commonly in the cerebral white matter. It typically affects the elderly and persons with damage to the intracerebral arterioles because of a long history of systemic hypertension. Additional causes include thrombolytics, anticoagulants, alcohol abuse, bleeding diathesis, infections, neoplasms, cerebral amyloid angiopathy, and arteriovenous malformations. Although ICH is only responsible for 15% of all strokes, it causes death in approximately 40% of those affected.

Elevated levels of low-density lipoprotein cholesterol (LDL-C) have long been identified as a risk factor for stroke and heart disease. Guidelines have grown increasingly stringent in their recommendations of appropriate levels of LDL-C in certain patient populations. Very high-risk patients are encouraged to maintain LDL-C concentrations at less than 70 mg/dL, but that could change.

What You Need to Know:

Findings from a study of more than 96,000 participants that examined the relationship between LDL-C levels and risk for ICH may help clinicians hone in on an appropriate cholesterol target for their patients. Qualifying research subjects were enrolled if they did not have a history of myocardial infarction, stroke, or cancer at the beginning of the study. Their serum LDL-C levels were tested four times between 2006 and 2012, at two-year intervals. Intracranial hemorrhage was identified in enrolled subjects through a review of health records during the study. Results showed that men and women with serum LDL-C levels below 70 mg/dL demonstrated a significantly higher risk of developing ICH than participants with serum LDL-C levels between 70 and 99 mg/dL. Additional research is needed to help confirm these findings.

Read More about Intracerebral Hemorrhage:

The Color Atlas and Synopsis of Family Medicine, 3e: Chapter 241. Cerebral Vascular Accident

Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e: Chapter 167. Stroke Syndromes

Adam’s and Victor’s Principles of Neurology, 11e: Chapter 33. Stroke and Cerebrovascular Diseases

Clinical Neurology, 10e: Chapter 13. Stroke