Given the complex relationship between total choles- terol and stroke, it is noteworthy that there appears to be no positive association between total cholesterol and stroke HDL Cholesterol Some epidemiological studies have shown an inverse rela- tionship between HDL cholesterol and risk of stroke,141 145 whereas others have not.134 The Emerging Risk Factors Collaboration performed a meta-analysis involving individual records on 302430 people without vascular disease from 68 long-term prospective studies.146 Collectively, there were 2.79 million person-years of follow-up. The aggregated data set included 2534 ischemic strokes, 513 hemorrhagic strokes, and 2536 unclassified strokes. The analysis adjusted for risk fac- tors other than lipid levels and corrected for regression dilu- tion. The adjusted HRs were 0.93 (95% CI, 0.84 1.02) for ischemic stroke, 1.09 (95% CI, 0.92 1.29) for hemorrhagic stroke, and 0.87 (95% CI, 0.80 0.94) for unclassified stroke. There was modest heterogeneity among studies of ischemic =27%). The absence of an association between HDL and ischemic stroke and between HDL and hemorrhagic stroke contrast with the clear inverse association between HDL cholesterol and coronary heart disease observed in the same meta-analysis. Triglycerides Epidemiological studies that have evaluated the relationship between triglycerides and ischemic stroke have been inconsis- tent, in part because some have used fasting and others used nonfasting levels. 