Relation of consumption of vitamin E, vitamin C, and carotenoids to risk for stroke among men in the United States

Background: Antioxidants increase the resistance of low-density lipoprotein to oxidation and may thereby reduce risk for atherosclerosis. Objective: To determine whether intake of vitamin E, vitamin C, or caroteno ids predict risk for total or ischemic stroke. Design: Prospective observational study. Setting: The Health Professionals Follow-up Study. Participants: 43 738 men 40 to 75 years of age who did not have cardiovascu lar disease or diabetes. Measurements: Repeated and validated dietary assessments were done by using a self-administered 131-item food-frequency questionnaire, which included questions on dose and duration of vitamin supplement use. The follow-up per iod was 8 years. Results: A total of 328 strokes occurred: 210 ischemic, 70 hemorrhagic, and 48 unclassified. After adjustment for age, smoking, hypertension, hypercho lesterolemia, body mass index, physical activity, parental history of myoca rdial infarction, alcohol consumption, and total energy intake, the relativ e risk for ischemic stroke in the top quintile of vitamin E intake (median, 411 IU/d) compared with the bottom quintile (5.4 IU/d) was 1.18 (95% Cl, 0 .77 to 1.82). The relative risk for ischemic stroke in the top quintile of vitamin C intake (1167 mg/d) compared with the bottom quintile (95 mg/d) wa s 1.03 (Cl, 0.66 to 1.59). Results for total stroke were similar. Associati ons of vitamin intake with hemorrhagic stroke were also nonsignificant, but the Cls were wide. Neither dose nor duration of vitamin E or vitamin C sup plement use was related to risk for total or ischemic stroke. The relative risk for ischemic stroke was 1.16 (Cl, 0.81 to 1.67) in men using 250 IU or more of vitamin E supplementation per day compared with men who used no vi tamin E supplements and was 0.93 (Cl, 0.60 to 1.45) in men using 700 mg or more of vitamin C supplementation per day compared with men who used no vit amin C supplements. A significant inverse relation between lutein intake an d risk for ischemic stroke was seen but was not independent of other dietar y factors. Conclusions: Vitamin E and vitamin C supplements and specific carotenoids d id not seem to substantially reduce risk for stroke in this cohort. Modest effects, however, cannot be excluded.