Low levels of "good" cholesterol make it difficult to recover from stroke

People are at an increased risk of memory problems and greater disability after stroke if they have low levels of "good" cholesterol and high levels of homocysteine, an amino acid acquired mostly from eating meat.

The findings are published in the November 27, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology.

“These findings show metabolic stress plays a significant role in stroke recovery,” said study author George C. Newman, MD, PhD, with Albert Einstein Healthcare Network in Philadelphia, PA, and member of the American Academy of Neurology.

The study involved 3,680 men and women over age 35 in the United States, Canada, and Scotland who had suffered a mild to moderate stroke within the past three months. The participants underwent cognitive and disability tests and were followed for two years.

Researchers found several factors predicted memory and disability problems after stroke: increased age, non-Caucasian race, recurrent stroke, diabetes, stroke in the left hemisphere of the brain, higher levels of homocysteine and lower levels of high-density lipoproteins (HDL), otherwise known as “good” cholesterol.

“People with low levels of HDL, high levels of homocysteine, and diabetes are twice as likely as those without such problems to have poorer cognitive function and greater disability after stroke,” said Newman. “The study also found stroke recovery was the most difficult for people over the age of 57 with high levels of homocysteine, which is a risk factor for heart problems and associated with low levels of vitamin B6, B12, folic acid and kidney disease.”

Newman says it's unclear why these factors are contributing to a slower stroke recovery and more research is needed. “We need to focus our attention on identifying and treating these vascular risk factors since they can be modified.”