Is Ischemic Stroke Risk Related to Folate Status or Other Nutrients Correlated With Folate Intake?

Abstract

Background and Purpose-Folate status was inversely associated with plasma homocysteine concentration, a potential risk factor of cardiovascular disease. However, it is uncertain whether folate is causally associated with risk of ischemic stroke (IS). We aimed to examine the association between IS incidence and folate intake, biochemical folate status, and folate associated nutrients. Methods-Information on baseline characteristics and food frequency questionnaire was collected in 1990 to 1993 and included for analyses data from 1772 adults over 40 years, who were free of stroke and cancer at baseline from the CardioVascular Disease risk FACtor Two-township Study. Multivariate Cox proportional hazard model was used to relate baseline nutrient status with IS event. Results-Over an average of 10.6 years of follow-up, 132 incident IS events were documented. Low folate intake (1st and 2nd quartiles) was significantly and independently associated with increased IS risk (HRϭ1.61; 95% CI: 1.04 to 2.48 and HRϭ1.82; 95% CI: 1.20 to 2.76) compared with those in the 3rd and 4th quartile combined, whereas no association was observed for plasma folate concentration. On the other hand, several nutrients correlated with dietary folate: vitamin B2, potassium, iron, vitamin A of plant origin, calcium were also associated with IS risk in an inverse linear manner with HR ranging from 1.5 to 1.9 for the first quartile. Conclusions-The

Heme Iron Intake and Risk of Stroke

“…A few epidemiological studies have investigated the relation between total iron intake and incidence of stroke with conflicting results. [21][22][23] In a case-control study, high intake of total iron was related to a nonsignificant increased risk of ischemic stroke. 21 In one prospective study, there was a statistically significant inverse association between total iron intake and risk of ischemic stroke, 23 but not in other.…”

“…[21][22][23] In a case-control study, high intake of total iron was related to a nonsignificant increased risk of ischemic stroke. 21 In one prospective study, there was a statistically significant inverse association between total iron intake and risk of ischemic stroke, 23 but not in other. 22 There are also a few prospective studies [32][33][34] and studies of stroke patients [35][36][37] relating iron status in blood to risk of stroke.…”

“…Only a few studies have investigated the relation between total iron intake and risk of stroke, and the results are inconsistent. [21][22][23] Identification of nutritional factors that affect the risk of stroke is relevant from a public health point of view. According to the American Heart Association Report, each year about 795 000 individuals experience a new or recurrent stroke, and every 4 minutes in USA someone dies from the disease.…”

Dietary Potassium Intake and Risk of Stroke

“…Thirteen full-text articles were reviewed. [15][16][17][18][19][20][21][22][23][24][25][26][27] We excluded 1 study because a RR was reported only for the highest versus the lowest tertile of potassium intake. 19 Another study was excluded because no RRs were reported.…”

“…Five studies provided results for stroke subtypes. 18,23,24,26,27 For those studies, the pooled RRs for a 1000-mg/day increase in potassium intake were 0.89 (95% CI, 0.81 to 0.97) for ischemic stroke, 0.95 (95% CI, 0.83 to 1.09) for intracerebral hemorrhage, and 1.08 (95% CI, 0.92 to 1.27) for subarachnoid hemorrhage.…”