Low-density lipoprotein cholesterol (LDL-C) levels were negatively associated with HT, but high-density lipoprotein cholesterol (HDL-C)levels were positively associated with HT. The association between LDL-C/HDL-C ratio and HT in acute ischemic stroke (AIS) patients remains unclear.

Data from the Chengdu Stroke Registry on consecutive AIS patients admitted to West China Hospital within 7 days of stroke onset from January 2016 to June 2017 were included. Clinico-demographic characteristics including lipid profiles tests were collected. Patients were divided into three categories based on LDL-C/HDL-C ratio tertiles. HT was defined by the magnetic resonance imaging or computed tomography.

We enrolled 968 patients (612 males; mean age, 63.89±14.60years), of whom 116 patients (11.98%) presented with HT. According to LDL-C/HDL-C ratio tertiles (tertile 1<1.70; tertile2=1.70-2.48; and tertile3>2.48), all patients were divided into three categories including tertile 1(n=320, 190 males, mean age, 66.72±15.32years), tertile 2(n=330, 204 males, mean age, 63.39±14.34years) and tertile 3(n=318, 218 males, mean age, 61.56±13.65years). The number of HT was 55(17.2%), 31(9.1%) and 30(9,7%) from tertile 1 to tertile 3. After adjustment for age, male gender, atrial fibrillation, SBP and National Institutes of Health Stroke Scale score on admission, a low LDL-C/HDL-C ratio was significantly associated with HT (OR 0.517, 95%CI 0.308 to 0.866, P = 0.012).

Our research founded that a low LDL-C/HDL-C ratio was independently associated with HT in AIS patients within 7 days. Future work should be aimed to elucidate how lipid levels contribute to HT and explore comprehensive factors of predicting HT.