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(Stroke. 2003;34:367.)
© 2003 American Heart Association, Inc.

Advances in Stroke 2002

Prevention and Health Services Delivery

Larry B. Goldstein, MD

From the Duke Center for Cerebrovascular Disease, Stroke Policy Program, Center for Clinical Health Policy Research, Duke University and Durham VA Medical Center, Durham, North Carolina.

Address correspondence to Larry B. Goldstein, MD, Box 3651, Duke Medical Center, Durham, NC 27710. E-mail golds004@mc.duke.edu

Key Words: diet • health services • hypertension • lipids • prevention

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The burden of stroke to the health care system in the United States continues to increase. Stroke-related hospital admissions grew from 580 000 in 1988 to 820 000 in 1997, an 18.6% increase after age adjustment.¹ More effective stroke prevention provides the primary means of reducing these alarming statistics. This can be accomplished through better implementation of known preventive strategies² and through research into new approaches to stroke prevention.

Diet can affect stroke risk, with epidemiological studies indicating an inverse relationship between fruit and vegetable consumption and cardiovascular events.² For example, one study including individuals free of cardiovascular disease at baseline found that the relative risk (RR) of stroke was reduced by 31% (RR, 0.69; 95% CI, 0.52 to 0.92) for persons in the highest quintile of fruit and vegetable intake.³ Analysis of data from the National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study supports these results.⁴ The study included 9608 adults aged 25 to 74 years who were free of cardiovascular disease at a baseline evaluation between 1971 and 1975. Consumption of fruits and vegetables 3 times per day compared with <1 time per day was associated with a 27% lower stroke incidence (RR, 0.73; 95% CI, 0.57 to 0.95) after adjustment for potential confounders, suggesting the benefit is not attributable to a healthy-user effect. The results reinforce present recommendations for an intake of 5 servings of fruits and vegetables daily.

Because fruits and vegetables contain antioxidants, antioxidant food supplements might be expected to have similar benefits. . . . [Full Text of this Article]

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