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Stroke is the second leading cause of death worldwide and accounts for >2 million deaths annually in China^,. Ischemic stroke (IS) and intracerebral hemorrhage (ICH) account for an equal number of deaths in China, despite a fourfold greater incidence of IS^,. Stroke incidence and ICH proportion are higher in China than in Western populations^{, –}, despite having a lower mean low-density lipoprotein cholesterol (LDL-C) concentration. Observational studies reported weaker positive associations of LDL-C with IS than with coronary heart disease (CHD)^,, but LDL-C-lowering trials demonstrated similar risk reductions for IS and CHD^{, –}. Mendelian randomization studies of LDL-C and IS have reported conflicting results^{, –}, and concerns about the excess risks of ICH associated with lowering LDL-C^, may have prevented the more widespread use of statins in China. We examined the associations of biochemically …