HYPERLIPIDAEMIA AND CARDIOVASCULAR DISEASE: Edited by Paul N. DurringtonGenetic determinants of LDL cholesterol and risk of intracerebral haemorrhageSzejko, Nataliaa,b,c; Kirsch, Elaynaa,d; Falcone, Guido J.a Author Information aDivision of Neurocritical Care & Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA bDepartment of Neurology cDepartment of Bioethics, Medical University of Warsaw, Warsaw, Poland dDuke University School of Medicine, Durham, North Carolina, USA Correspondence to Guido J. Falcone, MD, ScD, MPH, 15 York Street, LLCI Room 1004D, P.O. Box 20801, New Haven, CT 06510, USA. E-mail: [email protected] Current Opinion in Lipidology: August 2021 - Volume 32 - Issue 4 - p 244-248 doi: 10.1097/MOL.0000000000000761 Buy Metrics Abstract Purpose of review The role of lipids in spontaneous, nontraumatic intracerebral haemorrhage (ICH) remains controversial, as some studies suggest that lower levels of total and LDL cholesterol could increase the risk of this disease. Because of their random assortment during meiosis, genetic variants known to associate with lipid levels can be used as instruments to evaluate this relationship from a causal perspective. The purpose of this review is to summarize the existing literature related to genetically determined LDL cholesterol levels and risk of ICH. Recent findings A number of studies have demonstrated that lower LDL levels are associated with a higher risk of ICH and a higher burden of neuroimaging markers of cerebral small vessel disease, such as microbleeds and white matter hyperintensity volume. As for genetically elevated lipid levels, several studies confirmed an inverse association between LDL levels and ICH. However, a number of observational studies and large meta-analyses of clinical trials of statins have failed to show such association. Summary Observational studies and clinical trials of statins have yielded inconsistent results regarding a possible link between LDL levels and the risk of ICH. Genetic studies focused on genetically elevated LDL levels and risk of ICH have, for the most, found an inverse association. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.