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(Stroke. 2004;35:1584.)
© 2004 American Heart Association, Inc.

Original Contributions

Prospective Study of Plasma Carotenoids and Tocopherols in Relation to Risk of Ischemic Stroke

A. Elisabeth Hak, MD, PhD; Jing Ma, MD, PhD; Calpurnyia B. Powell, BS; Hannia Campos, PhD; J. Michael Gaziano, MD; Walter C. Willett, MD, DrPH Meir J. Stampfer, MD, DrPH

From the Departments of Epidemiology (A.E.H., C.B.P., W.C.W., M.J.S.) and Nutrition (J.M., W.C.W., M.J.S., H.C.), Harvard School of Public Health, Boston, Mass; Channing Laboratory (J.M., W.C.W., M.J.S.) and the Division of Preventive Medicine (J.M.G., M.J.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; VA Boston Healthcare System (J.M.G.), Boston, Mass; and the Departments of Epidemiology & Biostatistics and Internal Medicine (A.E.H.), Erasmus MC, Rotterdam, the Netherlands.

Correspondence to Dr Jing Ma, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, 181 Longwood Avenue, Boston, MA 02115-5804. E-mail jing.ma{at}channing.harvard.edu

Background and Purpose— Intake of fruits and vegetables has been related to lower risk of ischemic stroke, but nutrients responsible for this apparent benefit remain ill-defined. Tocopherols (vitamin E) have also been proposed to be protective.

Methods— We conducted a prospective, nested case-control analysis among male physicians without diagnosed cardiovascular disease followed-up for up to 13 years in the Physicians’ Health Study. Samples from 297 physicians with ischemic stroke were analyzed with paired controls, matched for age and smoking, for 5 major carotenoids (- and ß-carotene, ß-cryptoxanthin, lutein, and lycopene), retinol, and - and -tocopherol.

Results— Baseline plasma levels of -carotene and ß-carotene and lycopene tended to be inversely related to risk of ischemic stroke with an apparent threshold effect. As compared with men whose plasma levels were in the lowest quintile, the multivariate adjusted odds ratios (ORs) of ischemic stroke among men with levels in the second through fifth quintiles were 0.59 (95% CI, 0.36 to 0.98) for -carotene, 0.62 (95% CI, 0.38 to 1.01) for ß-carotene, and 0.61 (95% CI, 0.37 to 1.00) for lycopene. A tendency toward an inverse association was found for ß-cryptoxanthin, but the result was not statistically significant. No association was found for lutein, retinol, and tocopherols.

Conclusion— Our data suggest that higher plasma levels of carotenoids, as markers of fruit and vegetable intake, are inversely related to risk of ischemic stroke and provide support for recommendations to consume fruits and vegetables regularly.

Key Words: antioxidants • carotenoids • tocopherols • ischemic stroke

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