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Significant decrease of serum high density lipoprotein cholesterol (HDL-C) in cerebrovascular diseases (CVD) was mentioned in our previous report (1981). The results of further studies on lipoprotein patterns of 425 cases of various CVD are presented. Reduction of HDL level (including both HDL-C and apolipoprotein A1) was observed not only in the group of patients hospitalized due to apoplexy (cerebral infarction or hemorrhage), but also in patients under normal living conditions. The latter group included patients with cerebrovascular insufficiency, transient ischemic attacks mild residual neuro-muscular symptoms after recovery from stroke. It is surmised that HDL lowering was present early in CVD cases before attack of apoplexy and is one of the risk factors of CVD The degree of HDL lowering in CVD groups were much more marked than that in our reported cases of coronary heart disease (CHD). The prominent change of lipoprotein pattern in CHD group was elevation of apoB and total cholesterol (TC); however, apoB and TC were approximately normal or significantly lower in certain CVD groups.