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(Stroke. 2005;36:222.)
© 2005 American Heart Association, Inc.

Advances in Stroke 2004

Prevention and Health Services Delivery

From the Department of Medicine (Neurology; L.B.G.), Duke Center for Cerebrovascular Disease, Stroke Policy Program, Center for Clinical Health Policy Research, Duke University and Veterans Affairs Medical Center, Durham, NC; and the Department of Neurology and Stroke Center (P.A.), Bichat University Hospital and Medical School, Denis Diderot University–Paris VII, France.

Correspondence to Dr Larry B. Goldstein, Center for Clinical Health Policy Research, Box 3651, Duke University Medical Center, Durham, NC 27710. E-mail golds004@mc.duke.edu

Key Words: Advances in Stroke • delivery of health care • stroke prevention

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

The American Heart Association continues to estimate that >700 000 Americans have a stroke each year.¹ Stroke also continues to be a major health problem in Europe and Asia. Prevention and more effective delivery of established interventions remain major strategies for reducing this growing burden.

Current American Heart Association primary stroke prevention guidelines recommend a diet rich in fruits and vegetables.² Cardiovascular and stroke risk-reduction benefits are thought to be at least in part related to the antioxidant vitamin content of these foods. However, last year, a meta-analysis of 7 randomized trials of vitamin E comprising 81 788 patients and 8 studies of beta carotene comprising 138 113 patients found neither had significant cardiovascular benefits.³ There was no reduction in stroke rates with either vitamin (3.6% with versus 3.5% without vitamin E, P=0.31; and 2.3% with versus 2.3% without beta carotene). The relationship between the intake of fruits and vegetables and the risk of ischemic stroke was investigated in a prospective cohort study of 54 506 Danish men and women.⁴ Total intakes of fruits and vegetables were obtained from a baseline questionnaire with rates of ischemic stroke obtained through a national registry and verified by record reviews. In contrast with the antioxidant vitamin studies, after adjustment for potential confounders (sex, total energy intake, smoking status, blood pressure, serum cholesterol, diabetes mellitus, body mass index, alcohol intake, intake of red meat and n-3 polyunsaturated fatty acids, physical activity, and education), persons in the top quintile of fruit and vegetable intake . . . [Full Text of this Article]