Apolipoprotein A-I and B and Stroke Events in a Community-Based Cohort in Taiwan

Background and Purpose — There are limited prospective cohort studies of the well-known association between stroke events and serum lipids for the Taiwanese population, in whom stroke is the second most common cause of death. Methods — This report describes the effect of dyslipidemia on the risk of stroke in a community-based cohort consisting of 3602 adults aged ≥35 years, established in 1990 in the Chin-Shan community in Taipei County, Taiwan. Results — As of the end of 1998, 97 stroke incidence cases were identified from medical records and death certificates (53 in men and 44 in women). The female-to-male stroke event rates increased from 0.42 in the youngest group (aged 35 to 44 years) to 1.38 in the oldest (aged ≥75 years). Multiple Cox proportional hazard regression models controlling for age and sex revealed that individuals with serum apolipoprotein A-I (apoA-I) at the highest quartile were more likely to have a stroke event than those at the lowest quartile level (relative risk [RR]=2.02, P for trend=0.010). The corresponding risk of stroke predicted by apolipoprotein B (apoB) was also significant (RR=1.88, P for trend=0.020). After adjustment for age, sex, hypertension, and diabetes status, the interaction between hypertension and apoA-I level remained significant in predicting stroke events in men but not in women (RR=1.71, P =0.033 in men; RR=2.29, P =0.071 in women). Conclusions — We conclude that apoA-I but not apoB levels may serve as an effect modifier of hypertension for the risk of stroke events.