Vitamin Supplementation and Stroke Prevention

Hankey, Graeme J.

doi:10.1161/strokeaha.111.639930

Cited by 15 publications

(8 citation statements)

References 43 publications

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“…Furthermore, our meta-analyses showed no significant preventive action of vitamin E in total stroke, fatal stroke and non-fatal stroke. Our findings confirm a result published in the journal of the American Heart Association 59 which reported that there was no statistical difference favouring the vitamin E group compared with the control group in stroke prevention. However, TSA indicated that the current evidence for total stroke, fatal stroke and non-fatal stroke was insufficient to draw solid conclusions.…”

Section: Discussionsupporting

confidence: 91%

Effects of vitamin E on stroke: a systematic review with meta-analysis and trial sequential analysis

et al. 2020

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There are several previous studies on the association of vitamin E with prevention of stroke but the findings remain controversial. We have conducted a systematic review, meta-analysis together with trial sequential analysis of randomised controlled trials to evaluate the effect of vitamin E supplementation versus placebo/no vitamin E on the risk reduction of total, fatal, non-fatal, haemorrhagic and ischaemic stroke. Relevant studies were identified by searching online databases through Medline, PubMed and Cochrane Central Register of Controlled Trials. A total of 18 studies with 148 016 participants were included in the analysis. There was no significant difference in the prevention of total stroke (RR (relative risk)=0.98, 95% CI 0.92–1.04, p=0.57), fatal stroke (RR=0.96, 95% CI 0.77–1.20, p=0.73) and non-fatal stroke (RR=0.96, 95% CI 0.88–1.05, p=0.35). Subgroup analyses were performed under each category (total stroke, fatal stroke and non-fatal stroke) and included the following subgroups (types of prevention, source and dosage of vitamin E and vitamin E alone vs control). The findings in all subgroup analyses were statistically insignificant. In stroke subtypes analysis, vitamin E showed significant risk reduction in ischaemic stroke (RR=0.92, 95% CI 0.85–0.99, p=0.04) but not in haemorrhagic stroke (RR=1.17, 95% CI 0.98–1.39, p=0.08). However, the trial sequential analysis demonstrated that more studies were needed to control random errors. Limitations of this study include the following: trials design may not have provided sufficient power to detect a change in stroke outcomes, participants may have had different lifestyles or health issues, there were a limited number of studies available for subgroup analysis, studies were mostly done in developed countries, and the total sample size for all included studies was insufficient to obtain a meaningful result from meta-analysis. In conclusion, there is still a lack of statistically significant evidence of the effects of vitamin E on the risk reduction of stroke. Nevertheless, vitamin E may offer some benefits in the prevention of ischaemic stroke and additional well-designed randomised controlled trials are needed to arrive at a definitive finding. PROSPERO registration number: CRD42020167827.

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Section: Discussionsupporting

confidence: 91%

Effects of vitamin E on stroke: a systematic review with meta-analysis and trial sequential analysis

et al. 2020

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“…Nevertheless, two studies showed that the increased intake of vitamins E and C and β -carotene compared to placebo did not reduce the incidence of all-cause and cardiovascular mortality [58, 59]. …”

Section: Carotenoids and Cardiovascular Healthmentioning

confidence: 99%

Dietary Intake of Carotenoids and Their Antioxidant and Anti-Inflammatory Effects in Cardiovascular Care

Ciccone

Cortese

Gesualdo

et al. 2013

Mediators of Inflammation

240

165

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Cardiovascular disease related to atherosclerosis represents nowadays the largest cause of morbidity and mortality in developed countries. Due to inflammatory nature of atherosclerosis, several studies had been conducted in order to search for substances with anti-inflammatory activity on arterial walls, able to exert beneficial roles on health. Researches investigated the role of dietary carotenoids supplementation on cardiovascular disease, due to their free radicals scavenger properties and their skills in improving low-density lipoprotein cholesterol resistance to oxidation. Nevertheless, literature data are conflicting: although some studies found a positive relationship between carotenoids supplementation and cardiovascular risk reduction, others did not find any positive effects or even prooxidant actions. This paper aimed at defining the role of carotenoids supplementation on cardiovascular risk profile by reviewing literature data, paying attention to those carotenoids more present in our diet (β-carotene, α-carotene, β-cryptoxanthin, lycopene, lutein, zeaxanthin, and astaxanthin).

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“…Similarly, the findings of a previously published RCT also suggested no statistical difference favoring vitamin E supplements in stroke prevention. [19] Accordingly, Prentice et al [20] and Nagao et al [18] found a non-significant association between serum vitamin E levels and death from cardiovascular disease. There is currently insufficient evidence from RCTs to reliably conclude whether plasma vitamin E is a risk factor for stroke.…”

Section: Discussionmentioning

confidence: 99%

Vitamin E and risk of first stroke in general hypertensive patients: a nested case–control study

Siddiqi,

Chen,

et al. 2023

Precision Nutrition

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Background: Epidemiological studies on the association between levels of plasma vitamin E and first stroke risk are inconclusive. Methods: A nested, case–control study was conducted utilizing data on 115,337 hypertensive patients from the H-type Hypertension and Stroke Prevention and Control Project. The current analysis comprised 2193 cases of first stroke and 2193 controls matched for age, sex, and study site. Results: The mean plasma concentration of vitamin E was 12.37 (3.61) μg/mL. The smoothing curve showed a linear correlation between plasma vitamin E levels and the risk of the first stroke. Hypertensive patients with plasma vitamin E levels ≥14.1 μg/mL (Q4) had an increased risk of first stroke (adjusted odds ratios [OR]: 1.18; 95% confidence interval [CI]: 1.01, 1.37) compared with those with plasma vitamin E < 14.1 μg/mL (Q1–Q3). Sub-group analysis revealed that the relationship between plasma vitamin E (≥14.1.1 vs. P interaction = 0.035). Conclusions: This study suggests that higher levels of plasma vitamin E are associated with an elevated risk of first stroke among Chinese hypertensive patients.

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Vitamin Supplementation and Stroke Prevention

Cited by 15 publications

References 43 publications

Effects of vitamin E on stroke: a systematic review with meta-analysis and trial sequential analysis

Effects of vitamin E on stroke: a systematic review with meta-analysis and trial sequential analysis

Dietary Intake of Carotenoids and Their Antioxidant and Anti-Inflammatory Effects in Cardiovascular Care

Vitamin E and risk of first stroke in general hypertensive patients: a nested case–control study

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