Cholesterol as a Risk Factor for Subarachnoid Hemorrhage : A Systematic Review

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Lindbohm , J V , Kaprio , J & Korja , M 2016 , ' Cholesterol as a Risk Factor for Subarachnoid Hemorrhage : A Systematic Review ' , PLoS One , vol. 11 , no. 4 , 0152568 .

Title: Cholesterol as a Risk Factor for Subarachnoid Hemorrhage : A Systematic Review
Author: Lindbohm, Joni Valdemar; Kaprio, Jaakko; Korja, Miikka
Contributor organization: Clinicum
Department of Public Health
Neurokirurgian yksikkö
Department of Neurosciences
Jaakko Kaprio / Principal Investigator
Institute for Molecular Medicine Finland
Genetic Epidemiology
Date: 2016-04-14
Language: eng
Number of pages: 15
Belongs to series: PLoS One
ISSN: 1932-6203
Abstract: Background The role played by total cholesterol (TC) in risk for subarachnoid hemorrhage (SAH) is unclear because studies report both high and low TC each as a risk factor. We performed a systematic review to clarify associations between lipid profile and SAH. Methods Our literature search comprised Pubmed, Scopus, and Cochrane Library databases with no language, publication year, or study type limitations. The Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist guided our reporting. Data forms adapted from the Critical Appraisal Skills Program (CASP), and Cochrane Collaboration guidelines provided a platform for risk-of-bias evaluation. We used a random effects model to calculate pooled estimates and assessed heterogeneity with I-2-statistics. Results Of the final 21 studies reviewed, 12 were prospective and 9 retrospective. All studies assessed TC, four assessed HDL, and none LDL in risk for SAH. Heterogeneity among all, retrospective, and Asian studies was high (I-2 = 79.5%, I-2 = 89.0%, and I-2 = 84.3%) and considerable in prospective (I-2 = 46.0%). We therefore focused on qualitative analysis and found that only two studies had a low risk of bias. According to these studies high TC increases risk for SAH in men, whereas the role of HDL remained unclear. Conclusion The low-risk-of-bias studies suggest that elevated TC levels elevate risk for SAH in men. Due to the high prevalence of hypercholesterolemia, population attributable risk (PAR) of hypercholesterolemia may exceed the PARs of smoking and hypertension in men. Apart from diabetes and obesity, the risk-factor profile of SAH seems to resemble that of other cerebrovascular diseases, at least in men.
3112 Neurosciences
3142 Public health care science, environmental and occupational health
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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