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We thank Lima and colleagues for their comment on our article.1 Although intracranial hemorrhage (ICH) has a lower prevalence, it does account for almost half of stroke death and is associated with disproportionately high risk of disability.2 Thus, studying ICH is of clinical significance. In the current study with a large sample size and power, we found that individuals with low-density lipoprotein-C (LDL-C) <70 mg/dL had high future risk of ICH. It should be noted that this investigation is a population-based study with only 2% of participants using lipid-lowering medications.1 As mentioned in discussion, the observed results might not be generalized to other settings. However, in our subsequent meta-analysis including 12 prospective studies with 476,173 participants and 7,587 hemorrhagic stroke cases, similar results were obtained.3 Of note, a significant association between low LDL-C concentrations and a high ICH risk was observed in both Asians and Caucasians.3 Future studies should differentiate the potential effect of low LDL-C due to different reasons on ICH risk.
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Author disclosures are available upon request (journal{at}neurology.org).
- © 2020 American Academy of Neurology
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