Dataset Information

Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study.

ABSTRACT: Background: The association between plasma vitamin E levels and first stroke risk in men and women remains unclear. Objective: We aimed to examine the prospective association between plasma vitamin E and first stroke, and evaluate the effect modifiers for the association, among hypertensive patients. Design: The study sample was drawn from the China Stroke Primary Prevention Trial (CSPPT), which randomized a total of 20,702 hypertensive patients to a double-blind, daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. This nested case-control study, including 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site, was conducted after the completion of the CSPPT. Results: The median follow-up duration was 4.5 years. Among men, a significantly higher risk of first stroke (adjusted OR, 1.67; 95%CI: 1.01, 2.77) was found for those with plasma vitamin E ≥7.1 μg/mL (≥quartile 1) compared with those with plasma vitamin E < 7.1 μg/mL. Subgroup analyses further showed that the association between vitamin E (≥7.1 vs. <7.1 μg/mL) and first stroke in men was significantly stronger in non-drinkers (adjusted OR, 2.64; 95%CI: 1.41, 4.96), compared to current drinkers (adjusted OR, 0.84; 95% CI: 0.43, 1.66, P-interaction = 0.008). However, there was no significant association between plasma vitamin E and first stroke in women (P-interaction between sex and plasma vitamin E = 0.048). Conclusions: Among Chinese hypertensive patients, there was a statistically significant positive association between baseline plasma vitamin E and the risk of first stroke in men, but not in women. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT00794885, Identifier: NCT00794885.

SUBMITTER: Song Y

PROVIDER: S-EPMC8595403 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study.

Song Yun Y Li Jingyi J Liu Lishun L Xu Richard R Zhou Ziyi Z Xu Benjamin B Lin Tengfei T Chen Ping P Li Huan H Li Youbao Y Liu Chengzhang C Huang Xiao X Wang Binyan B Zhang Yan Y Li Jianping J Huo Yong Y Ren Fazheng F Xu Xiping X Zhang Hao H Qin Xianhui X

Frontiers in nutrition 20211103

Background: The association between plasma vitamin E levels and first stroke risk in men and women remains unclear. Objective: We aimed to examine the prospective association between plasma vitamin E and first stroke, and evaluate the effect modifiers for the association, among hypertensive patients. Design: The study sample was drawn from the China Stroke Primary Prevention Trial (CSPPT), which randomized a total of 20,702 hypertensive patients to a double-blind, daily trea ...[more]

PMID: 34805240

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Project description:IntroductionThe angiotensin-converting enzyme 2 (ACE-2) and its shedding product (soluble ACE-2 [sACE-2]) are implicated in adverse cardiovascular outcomes. However, the relationship between sACE-2 and stroke recurrence is unknown. Herein, we examined the relationship of sACE-2 with stroke recurrence in patients with ischemic stroke or transient ischemic attack.MethodsData were obtained from the Third China National Stroke Registry (CNSR-III). Eligible cases consisted of 494 patients who developed recurrent stroke within 1-year follow-up, and 494 controls were selected using age- and sex-matched with a 1:1 case-control ratio. Conditional logistic regressions were used to evaluate the association between sACE-2 and recurrent stroke. The main outcomes were recurrent stroke within 1 year.ResultsAmong 988 patients included in this study, the median (interquartile range) of sACE-2 was 25.17 (12.29-45.56) ng/mL. After adjustment for conventional confounding factors, the odds ratio (OR) with 95% confidence interval (CI) in the highest quartile versus the lowest quartile was 1.68 (1.12-2.53) for recurrent stroke within 1-year follow-up. Subgroup analysis showed that the association between elevated plasma level of sACE-2 and stroke recurrence was significant in patients with higher systemic inflammation, as indicated by high-sensitivity C-reactive protein ≥ 2 mg/L (adjusted OR: 2.33 [95% CI, 1.15-4.72]) and neutrophil counts ≥ median (adjusted OR: 2.66 [95% CI, 1.35-5.23]) but not significant in patients with lower systemic inflammation.Discussion/conclusionElevated plasma sACE-2 concentration was associated with increased risk of recurrent stroke.IntroductionThe angiotensin-converting enzyme 2 (ACE-2) and its shedding product (soluble ACE-2 [sACE-2]) are implicated in adverse cardiovascular outcomes. However, the relationship between sACE-2 and stroke recurrence is unknown. Herein, we examined the relationship of sACE-2 with stroke recurrence in patients with ischemic stroke or transient ischemic attack.MethodsData were obtained from the Third China National Stroke Registry (CNSR-III). Eligible cases consisted of 494 patients who developed recurrent stroke within 1-year follow-up, and 494 controls were selected using age- and sex-matched with a 1:1 case-control ratio. Conditional logistic regressions were used to evaluate the association between sACE-2 and recurrent stroke. The main outcomes were recurrent stroke within 1 year.ResultsAmong 988 patients included in this study, the median (interquartile range) of sACE-2 was 25.17 (12.29-45.56) ng/mL. After adjustment for conventional confounding factors, the odds ratio (OR) with 95% confidence interval (CI) in the highest quartile versus the lowest quartile was 1.68 (1.12-2.53) for recurrent stroke within 1-year follow-up. Subgroup analysis showed that the association between elevated plasma level of sACE-2 and stroke recurrence was significant in patients with higher systemic inflammation, as indicated by high-sensitivity C-reactive protein ≥ 2 mg/L (adjusted OR: 2.33 [95% CI, 1.15-4.72]) and neutrophil counts ≥ median (adjusted OR: 2.66 [95% CI, 1.35-5.23]) but not significant in patients with lower systemic inflammation.Discussion/conclusionElevated plasma sACE-2 concentration was associated with increased risk of recurrent stroke.

Dataset Information

Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study.

Publications

Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study.

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