We carried out a case control study at the University Hospital of Pointe-à-Pitre, Guadeloupe, during eight months. Seventy patients with ischaemic stroke and seventy age- and sex-matched controls were involved. A standard questionnaire reported clinical characteristics and medical history. Seventy-six per cent of patients suffered from hypertension. Obesity and diabetes were more frequent in the case group than in the control group. Serum creatinine concentration (86 vs 74 mumol/l; p < 0.001), total cholesterol (5.9 vs. 5.2 mmol/l; p < 0.001), apolipoprotein B (1.2 vs 1.0 g/l; p < 0.001) and lipoprotein (a) (82 vs 48 mg/dl; p < 0.001) were significantly higher in patients than controls. Multiple logistic regression analysis revealed that in addition to serum creatinine, serum apolipoprotein B, hypertension, obesity, serum lipoprotein (a) and diabetes mellitus were associated independently and significantly with ischaemic stroke. These findings have implications for clinical practice and further research particularly with respect to serum creatinine concentration as a marker of renal damage from hypertension and as a risk factor itself for cerebrovascular disease.