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(Stroke. 2000;31:2301.)
© 2000 American Heart Association, Inc.

Original Contributions

Intake of Flavonoids, Carotenoids, Vitamins C and E, and Risk of Stroke in Male Smokers

Tero Hirvonen, MSc; Jarmo Virtamo, MD; Pasi Korhonen, MSc; Demetrius Albanes, MD Pirjo Pietinen, DSc

From the Department of Nutrition, National Public Health Institute, Helsinki, Finland (T.H., J.V., P.K., P.P.), and Division of Clinical Sciences, National Cancer Institute, Bethesda, Md (D.A.).

Background and Purpose—Antioxidants may protect against atherosclerosis and thus prevent cerebrovascular disease. We studied the association between dietary antioxidants and subtypes of stroke.

Methods—The study cohort consisted of 26 593 male smokers, aged 50 to 69 years, without a history of stroke. They were participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study in Finland. The men completed a validated dietary questionnaire at baseline. Incident cases were identified through national registers.

Results—During a 6.1-year follow-up, 736 cerebral infarctions, 83 subarachnoid hemorrhages, and 95 intracerebral hemorrhages occurred. Neither dietary flavonols and flavones nor vitamin E were associated with risk for stroke. The dietary intake of ß-carotene was inversely associated with the risk for cerebral infarction (relative risk [RR] of highest versus lowest quartile 0.74, 95% CI 0.60 to 0.91), lutein plus zeaxanthin with risk for subarachnoid hemorrhage (RR 0.47, 95% CI 0.24 to 0.93), and lycopene with risks of cerebral infarction (RR 0.74, 95% CI 0.59 to 0.92) and intracerebral hemorrhage (RR 0.45, 95% CI 0.24 to 0.86). Vitamin C intake was inversely associated with the risk for intracerebral hemorrhage (RR 0.39, 95% CI 0.21 to 0.74). After simultaneous modeling of the antioxidants, a significant association remained only between ß-carotene intake and risk for cerebral infarction (RR 0.77, 95% CI 0.61 to 0.99).

Conclusions—Dietary intake of ß-carotene was inversely associated with the risk for cerebral infarction. No association was detected between other dietary antioxidants and risk for stroke.

Key Words: antioxidants • diet • epidemiology • stroke

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