Total Cholesterol, Severity of Stroke, and All-Cause Mortality

To the Editor:The association of blood cholesterol with the risk of stroke, a very important clinical and public health issue, appears to be in dispute. To fuel the debate, Olsen et al1 reported a study of 513 patients admitted in a Copenhagen, Denmark hospital with acute ischemic stroke. All study data, including measures of total serum cholesterol (TSC) and the severity of stroke, were collected on admission in the hospital, and poststroke 10-year all-cause mortality was ascertained. The severity of stroke was measured by the Scandinavian Stroke Scale that is based on a composite of neurological deficits, and severity was found to be correlated with the cerebral infarct size seen on CT scans. The authors found that poststroke TSC levels were inversely associated with the severity of stroke, cerebral infarct size, and mortality, which were adjusted for the covariates.1The authors concluded that “hypercholesterolemia primarily is associated with minor strokes due …