Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Reply to Comment on “Lower high-density lipoprotein cholesterol level is associated with hematoma expansion in acute intracerebral hemorrhage: association with hypertensive microangiopathy”

Hypertension Research (2026)Cite this article

We sincerely appreciate the thoughtful and constructive comments regarding our recent article entitled “Lower high-density lipoprotein cholesterol level is associated with hematoma expansion in acute intracerebral hemorrhage: association with hypertensive microangiopathy [1, 2].” We are grateful to the authors for their careful review and valuable insights, which help to further confirm and develop our findings. We fully acknowledge the limitations in our study, such as retrospective design, selection bias, and confounding factors, which have a potential to hamper the generalization of our results in diverse populations. We would like to provide detailed responses to each of the points raised.

First, regarding the timing of high-density lipoprotein cholesterol (HDL-C) collection and hematoma expansion (HE) evaluation, as mentioned in the manuscript [1], serum HDL-C was collected and evaluated only on admission. While we only included acute intracerebral hemorrhage (ICH) patients with onset to door time within 24 h, adjusted the model with onset to first CT time and hematoma profile such as hematoma volume, and assume that the effect of time course after the onset and ICH severity on HDL-C might be mitigated, as Xie et al. [2] pointed out, we admit that certain effects after the ICH onset, such as inflammatory response [3] or autonomic nerve response [4], must have had influence on HDL-C in the current study design. In order to elucidate the true effect of HDL-C on HE, it is necessary to evaluate the temporal changes in HDL-C levels before and after the onset of ICH.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Sato T, Tsuchimochi Y, Hamada Y, Kukihara K, Kawabata Y, Iwamoto K, et al. Lower high-density lipoprotein cholesterol level is associated with hematoma expansion in acute intracerebral hemorrhage: association with hypertensive microangiopathy. Hypertens Res. 2025;48:2326–38.

    Article  CAS  PubMed  Google Scholar 

  2. Xie H, Zhang X, Xie A. Comment on “Lower high-density lipoprotein cholesterol level is associated with hematoma expansion in acute intracerebral hemorrhage: association with hypertensive microangiopathy”. Hypertens Res. 2025. https://doi.org/10.1038/s41440-025-02471-x.

  3. Khovidhunkit W, Kim MS, Memon RA, Shigenaga JK, Moser AH, Feingold KR, et al. Effects of infection and inflammation on lipid and lipoprotein metabolism: mechanisms and consequences to the host. J Lipid Res. 2004;45:1169–96.

    Article  CAS  PubMed  Google Scholar 

  4. Wirtz PH, Ehlert U, Bärtschi C, Redwine LS, von Känel R. Changes in plasma lipids with psychosocial stress are related to hypertension status and the norepinephrine stress response. Metabolism. 2009;58:30–7.

    Article  CAS  PubMed  Google Scholar 

  5. Hamann GF, Strittmatter M, Hoffmann KH, Holzer G, Stoll M, Keshevar T, et al. Pattern of elevation of urine catecholamines in intracerebral haemorrhage. Acta Neurochir (Wien). 1995;132:42–7.

    Article  CAS  PubMed  Google Scholar 

  6. Dowlatshahi D, Smith EE, Flaherty ML, Ali M, Lyden P, Demchuk AMVISTA Collaborators Small intracerebral haemorrhages are associated with less haematoma expansion and better outcomes. Int J Stroke. 2011;6:20120–6.

    Article  Google Scholar 

  7. Song R, Hu M, Qin X, Qiu L, Wang P, Zhang X, et al. The roles of lipid metabolism in the pathogenesis of chronic diseases in the elderly. Nutrients. 2023;15:3433.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Chen YC, Chang KH, Chen CM. Genetic polymorphisms associated with spontaneous intracerebral hemorrhage. Int J Mol Sci. 2018;19:3879.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Dunca D, Chopade S, Gordillo-Marañón M, Hingorani AD, Kuchenbaecker K, Finan C, et al. Comparing the effects of CETP in East Asian and European ancestries: a Mendelian randomization study. Nat Commun. 2024;15:5302.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Zakai NA, Minnier J, Safford MM, Koh I, Irvin MR, Fazio S, et al. Race-dependent association of high-density lipoprotein cholesterol levels with incident coronary artery disease. J Am Coll Cardiol. 2022;80:2104–15.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Strokology, Stroke Center, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan

    Takeo Sato, Yuka Tsuchimochi, Yuki Hamada, Kaishi Kukihara, Yutaro Kawabata, Kana Iwamoto, Go Takaguchi & Hideki Matsuoka

  2. Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Yujiro Higuchi & Hiroshi Takashima

Authors
  1. Takeo Sato
    View author publications

    Search author on:PubMed Google Scholar

  2. Yuka Tsuchimochi
    View author publications

    Search author on:PubMed Google Scholar

  3. Yuki Hamada
    View author publications

    Search author on:PubMed Google Scholar

  4. Kaishi Kukihara
    View author publications

    Search author on:PubMed Google Scholar

  5. Yutaro Kawabata
    View author publications

    Search author on:PubMed Google Scholar

  6. Kana Iwamoto
    View author publications

    Search author on:PubMed Google Scholar

  7. Go Takaguchi
    View author publications

    Search author on:PubMed Google Scholar

  8. Yujiro Higuchi
    View author publications

    Search author on:PubMed Google Scholar

  9. Hideki Matsuoka
    View author publications

    Search author on:PubMed Google Scholar

  10. Hiroshi Takashima
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Takeo Sato.

Ethics declarations

Conflict of interest

Takeo Sato: reports lecture and travel fees from Pfizer Japan Inc. and Daiichi Sankyo Co. Ltd., and lecture fees from Kowa Co. Ltd., outside the submitted work. Yuka Tsuchimochi: none. Yuki Hamada: reports lecture fees from Daiichi Sankyo Co. Ltd., Medtronic Co. Ltd., Medico’s Hirata Co. Ltd., Johnson & Johnson Co. Ltd., Merit Medical Systems Inc., and Kaneka Co. Ltd. outside the submitted work. Kaishi Kukihara: none. Yutaro Kawabata: none. Kana Iwamoto: none. Go Takaguchi: none. Yujiro Higuchi: none. Hideki Matsuoka: reports lecture fees from Daiichi Sankyo Co. Ltd., Pfizer Co. Ltd., Otsuka Pharmaceutical Co. Ltd., Kowa Co. Ltd., UCB Japan Co. Ltd., Novartis Pharma Co. Ltd., and AstraZeneca Co. Ltd. outside the submitted work. Hiroshi Takashima: reports lecture fees from Daiichi Sankyo Co. Ltd., Otsuka Pharmaceutical Co. Ltd., Biogen Japan Ltd., Eisai Co. Ltd., FP Pharmaceutical Corp., Alnylam Pharmaceuticals Inc., Kyowa Kirin Co. Ltd., Alexion Pharmaceuticals Inc., argenx Japan K.K., CYBERDYNE Inc., Takeda Pharmaceutical Co. Ltd., CSL Behring K.K., Asahi Kasei Medical Co. Ltd., Chugai Pharmaceutical Co. Ltd., Sumitomo Pharma Co. Ltd., Amgen Inc., Japan Blood Products Organization, Cosmic Corporation Co. Ltd., and ONO PHARMACEUTICAL Co. Ltd. outside the submitted work. Hiroshi Takashima also reports scholarship donations from SHIN NIPPON BIOMEDICAL LABORATORIES Ltd. and Asahi Kasei Medical Co. Ltd. outside the submitted work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sato, T., Tsuchimochi, Y., Hamada, Y. et al. Reply to Comment on “Lower high-density lipoprotein cholesterol level is associated with hematoma expansion in acute intracerebral hemorrhage: association with hypertensive microangiopathy”. Hypertens Res (2026). https://doi.org/10.1038/s41440-026-02599-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41440-026-02599-4

Keywords

Search

Advanced search

Quick links