A recent study found consistent inverse associations between HDL cholesterol and the risk of total, ischemic, and hemorrhagic stroke among patients with type 2 diabetes mellitus (T2D). Researchers performed a retrospective cohort study of 27,113 blacks and 40,431 whites with T2D. They found:

• During a mean follow-up period of 3.0 years, 8,496 patients developed stroke (8,048 ischemic and 448 hemorrhagic).
• Multivariable-adjusted hazard ratios across levels of HDL at baseline (<30 [reference group], 30–39.9, 40–49.9, 50–59.9, 60–69.9, 70–79.9, and ≥80 mg/dL) were 1.00, 0.86, 0.77, 0.71, 0.71, 0.77, and 0.69 for total stroke, 1.00, 0.89, 0.82, 0.75, 0.78, 0.76, and 0.75 for ischemic stroke, and 1.00, 0.89, 0.69, 0.66, 0.47, and 0.94 for hemorrhagic stroke, respectively.
• When an updated mean value of HDL cholesterol was used, the inverse association of HDL cholesterol with stroke risk did not change.
• This inverse association was consistent among patients of different ages, races, sexes, body mass index, hemoglobin A1c levels, never and past or current smokers, and patients with and without using glucose-lowering, cholesterol-lowering, or antihypertensive agents.