Differential Associations of LDL-C, HDL-C, and Triglycerides with Ischemic and Hemorrhagic Stroke: A Cross-Sectional Study from Kitwe Teaching Hospital, Zambia

Background Stroke is a leading cause of disability and death globally, with ischemic and haemorrhagic subtypes presenting distinct etiological pathways. Dyslipidemia has been implicated as a modifiable risk factor, particularly in ischemic stroke, yet the role of specific lipid fractions—low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)—in differentiating stroke subtypes remains inadequately characterized in sub-Saharan African populations. Objective To investigate the association between lipid profile components and stroke subtype among acute and subacute stroke patients admitted to Kitwe Teaching Hospital in Zambia. Methods In this hospital-based cross-sectional study, 153 patients with clinically and radiologically confirmed acute or subacute stroke were consecutively recruited. Patients were categorized into ischemic or haemorrhagic stroke groups based on neuroimaging findings. Lipid parameters—including LDL-C, HDL-C, TG, and total cholesterol—were obtained from medical records. Multivariable logistic regression was used to assess the independent association between lipid levels and stroke subtype, adjusting for age, sex, and major cardiovascular comorbidities. Results Of the 153 patients (mean age 62.4 ± 10.2 years; 58.2% male), 78.4% had ischemic and 21.6% had hemorrhagic stroke. Elevated LDL-C levels (> 130 mg/dL) were significantly associated with increased odds of ischemic stroke (OR = 2.15; 95% CI: 1.12–4.13; p = 0.021), while low HDL-C levels (< 45 mg/dL) similarly conferred higher odds (OR = 1.89; 95% CI: 1.05–3.41; p = 0.034). Triglyceride levels showed no statistically significant association with stroke subtype (p = 0.362). Subgroup analyses suggested synergistic effects of dyslipidemia and hypertension in ischemic stroke pathogenesis. Conclusion Elevated LDL-C and reduced HDL-C are independently associated with ischemic stroke, underscoring their potential utility in risk stratification and targeted prevention. Routine lipid screening and early therapeutic intervention may reduce ischemic stroke burden in resource-limited settings. Further longitudinal studies are warranted to explore causal pathways and population-specific lipid thresholds.