Skip to main content Accessibility help
×
Home

Stroke: roles of B vitamins, homocysteine and antioxidants

  • Concepción Sánchez-Moreno (a1), Antonio Jiménez-Escrig (a2) and Antonio Martín (a3)

Abstract

In the present review concerning stroke, we evaluate the roles of B vitamins, homocysteine and antioxidant vitamins. Stroke is a leading cause of death in developed countries. However, current therapeutic strategies for stroke have been largely unsuccessful. Several studies have reported important benefits on reducing the risk of stroke and improving the post-stroke-associated functional declines in patients who ate foods rich in micronutrients, including B vitamins and antioxidant vitamins E and C. Folic acid, vitamin B6 and vitamin B12 are all cofactors in homocysteine metabolism. Growing interest has been paid to hyperhomocysteinaemia as a risk factor for CVD. Hyperhomocysteinaemia has been linked to inadequate intake of vitamins, particularly to B-group vitamins and therefore may be amenable to nutritional intervention. Hence, poor dietary intake of folate, vitamin B6 and vitamin B12 are associated with increased risk of stroke. Elevated consumption of fruits and vegetables appears to protect against stroke. Antioxidant nutrients have important roles in cell function and have been implicated in processes associated with ageing, including vascular, inflammatory and neurological damage. Plasma vitamin E and C concentrations may serve as a biological marker of lifestyle or other factors associated with reduced stroke risk and may be useful in identifying those at high risk of stroke. After reviewing the observational and intervention studies, there is an incomplete understanding of mechanisms and some conflicting findings; therefore the available evidence is insufficient to recommend the routine use of B vitamins, vitamin E and vitamin C for the prevention of stroke. A better understanding of mechanisms, along with well-designed controlled clinical trials will allow further progress in this area.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Stroke: roles of B vitamins, homocysteine and antioxidants
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Stroke: roles of B vitamins, homocysteine and antioxidants
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Stroke: roles of B vitamins, homocysteine and antioxidants
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Dr C. Sánchez-Moreno, fax +34 91 5493627, email csanchezm@if.csic.es

References

Hide All
1Acheson, RM & Williams, DR (1983) Does consumption of fruit and vegetables protect against stroke? Lancet i, 11911193.
2Pohjasvaara, T, Erkinjuntti, T, Ylikoski, R, et al. . (1998) Clinical determinants of poststroke dementia. Stroke 29, 7581.
3Kase, CS, Wolf, PA, Kelly-Hayes, M, et al. . (1998) Intellectual decline after stroke: the Framingham Study. Stroke 29, 805812.
4Henon, H, Lebert, F, Durieu, I, et al. . (1999) Confusional state in stroke: relation to preexisting dementia, patient characteristics, and outcome. Stroke 30, 773779.
5Patel, MD, Coshall, C, Rudd, AG, et al. . (2002) Cognitive impairment after stroke: clinical determinants and its associations with long-term stroke outcomes. J Am Geriatr Soc 50, 700706.
6Gale, CR, Martyn, CN, Winter, PD, et al. . (1995) Vitamin C and risk of death from stroke and coronary heart disease in cohort of elderly people. Br Med J 310, 15631566.
7Gale, CR, Martyn, CN & Cooper, C (1996) Cognitive impairment and mortality in a cohort of elderly people. Br Med J 312, 608611.
8Gonzalez-Gross, M, Marcos, A & Pietrzik, K (2001) Nutrition and cognitive impairment in the elderly. Br J Nutr 86, 313321.
9Singleton, CK & Martin, PR (2001) Molecular mechanisms of thiamine utilization. Curr Mol Med 1, 197207.
10Mesnard, F, Roscher, A, Garlick, AP, et al. . (2002) Evidence for the involvement of tetrahydrofolate in the demethylation of nicotine by Nicotiana plumbaginifolia cell-suspension cultures. Planta 214, 911919.
11Nilsson, K, Gustafson, L & Hultberg, B (1999) Plasma homocysteine is a sensitive marker for tissue deficiency of both cobalamines and folates in a psychogeriatric population. Dement Geriatr Cogn Disord 10, 476482.
12Sarkar, PK & Lambert, LA (2001) Aetiology and treatment of hyperhomocysteinaemia causing ischaemic stroke. Int J Clin Pract 55, 262268.
13Miller, JW, Green, R, Mungas, DM, et al. . (2002) Homocysteine, vitamin B6, and vascular disease in AD patients. Neurology 58, 14711475.
14Rogers, PJ (2001) A healthy body, a healthy mind: long-term impact of diet on mood and cognitive function. Proc Nutr Soc 60, 135143.
15Robinson, K (2000) Homocysteine, B vitamins, and risk of cardiovascular disease. Heart 83, 127130.
16Wang, HX, Wahlin, A, Basun, H, et al. . (2001) Vitamin B12 and folate in relation to the development of Alzheimer's disease. Neurology 56, 11881194.
17Ascherio, A, Rimm, EB, Hernan, MA, et al. . (1999) Relation of consumption of vitamin E, vitamin C, and carotenoids to risk for stroke among men in the United States. Ann Int Med 130, 963970.
18Leppälä, JM, Virtamo, J, Fogelholm, R, et al. . (2000) Vitamin E and β carotene supplementation in high risk for stroke: a subgroup analysis of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Arch Neurol 57, 15031509.
19Liu, SM, Manson, JE, Stampfer, MJ, et al. . (2000) Whole grain consumption and risk of ischemic stroke in women: a prospective study. JAMA 284, 15341540.
20Ranjan, A, Theodore, D, Haran, RP, et al. . (1993) Ascorbic acid and focal cerebral ischaemia in a primate model. Acta Neurochir 123, 8791.
21Simon, JA & Hudes, ES (1999) Serum ascorbic acid and cardiovascular disease prevalence in U.S. adults: the Third National Health and Nutrition Examination Survey (NHANES III). Ann Epidemiol 9, 358365.
22Feldman, EB (2001) Fruits and vegetables and the risk of stroke. Nutr Rev 59, 2427.
23Gillman, MW, Cupples, AL, Gagnon, D, et al. . (1995) Protective effect of fruits and vegetables on development of stroke in men. JAMA 273, 11131117.
24Yochum, LA, Folsom, AR & Kushi, LH (2000) Intake of antioxidant vitamins and risk of death from stroke in postmenopausal women. Am J Clin Nutr 72, 476483.
25Steiner, M (1995) Vitamin E may enhance the benefits of aspirin in preventing stroke. Am Fam Physician 51, 1977.
26Polasek, J (1997) Acetylsalicylic acid and vitamin E in prevention of arterial thrombosis. Can J Cardiol 13, 533535.
27Pryor, WA (2000) Vitamin E and heart disease: basic science to clinical intervention trials. Free Radic Biol Med 28, 141164.
28Lauber, RP & Sheard, NF (2001) The American Heart Association Dietary Guidelines for 2000: a summary report. Nutr Rev 59, 298306.
29Padro, L, Benacer, R, Foix, S, et al. . (2002) Assessment of dietary adequacy for an elderly population based on a Mediterranean model. J Nutr Health Aging 6, 3133.
30Klipstein-Grobusch, K, den Breeijen, JH, Grobbee, DE, et al. . (2001) Dietary antioxidants and peripheral arterial disease: the Rotterdam Study. Am J Epidemiol 154, 145149.
31Brussaard, JH, Löwik, MR, van den Berg, H, et al. . (1997) Folate intake and status among adults in the Netherlands. Eur J Clin Nutr 51, S46S50.
32de Bree, A, Verschuren, WMM, Blom, HJ, et al. . (2001) Association between B vitamin intake and plasma homocysteine concentration in the general Dutch population aged 20–65 y. Am J Clin Nutr 73, 10271033.
33Kelly, PJ & Furie, KL (2002) Management and prevention of stroke associated with elevated homocysteine. Curr Treat Options Cardiovasc Med 4, 363371.
34Liaugaudas, G, Jacques, PF, Selhub, J, et al. . (2001) Renal insufficiency, vitamin B12 status, and population attributable risk for mild hyperhomocysteinemia among coronary artery disease patients in the era of folic acid-fortified cereal grain flour. Arterioscler Thromb Vasc Biol 21, 849851.
35Green, R & Miller, JW (2005) Vitamin B12 deficiency is the dominant nutritional cause of hyperhomocysteinemia in a folic acid-fortified population. Clin Chem Lab Med 43, 10481051.
36Howard, VJ, Sides, EG, Newman, GC, et al. . (2002) Changes in plasma homocyst(e)ine in the acute phase after stroke. Stroke 33, 473478.
37Mezzano, D, Pais, EO, Aranda, E, et al. . (2001) Inflammation, not hyperhomocysteinemia, is related to oxidative stress and hemostatic and endothelial dysfunction in uremia. Kidney Int 60, 18441850.
38Strazzullo, P, Scalfi, L, Branca, E, et al. . (2004) Nutrition and prevention of ischemic stroke: present knowledge, limitations and future perspectives. Nutr Metab Cardiovasc Dis 14, 97114.
39Spence, JD (2003) Nutritional and metabolic aspects of stroke prevention. Adv Neurol 92, 173178.
40Gariballa, SE (2000) Nutritional factors in stroke. Br J Nutr 84, 517.
41Gariballa, SE (2000) Nutritional support in elderly patients. J Nutr Health Aging 4, 2527.
42Renaud, SC (2001) Diet and stroke. J Nutr Health Aging 5, 167172.
43Gariballa, SE, Parker, SG, Taub, N, et al. . (1998) Influence of nutritional status on clinical outcome after acute stroke. Am J Clin Nutr 68, 275281.
44Gariballa, SE, Parker, SG, Taub, N, et al. . (1998) Nutritional status of hospitalized acute stroke patients. Br J Nutr 79, 481487.
45Elmståhl, S, Bülow, M, Ekberg, O, et al. . (1999) Treatment of dysphagia improves nutritional conditions in stroke patients. Dysphagia 14, 6166.
46Dennis, M (2000) Nutrition after stroke. Br Med Bull 56, 466475.
47Westergren, A, Karlsson, S, Andersson, P, et al. . (2001) Eating difficulties, need for assisted eating, nutritional status and pressure ulcers in patients admitted for stroke rehabilitation. J Clin Nurs 10, 257269.
48Westergren, A, Ohlsson, O & Hallberg, IR (2001) Eating difficulties, complications and nursing interventions during a period of three months after a stroke. J Adv Nurs 35, 416426.
49Deschamps, V, Barberger-Gateau, P, Peuchant, E, et al. . (2001) Nutritional factors in cerebral aging and dementia: epidemiological arguments for a role of oxidative stress. Neuroepidemiology 20, 715.
50Spence, JD (2006) Nutrition and stroke prevention. Stroke 37, 24302435.
51Van Duyn, MA & Pivonka, E (2000) Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature. J Am Diet Assoc 100, 15111521.
52Bazzano, LA, He, J, Ogden, LG, et al. . (2002) Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Am J Clin Nutr 76, 9399.
53Gillman, MW, Cupples, LA, Millen, BE, et al. . (1997) Inverse association of dietary fat with development of ischemic stroke in men. JAMA 278, 21452150.
54Iso, H, Rexrode, KM, Stampfer, MJ, et al. . (2001) Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA 285, 304312.
55Zhang, J, Sasaki, S, Amano, K, et al. . (1999) Fish consumption and mortality from all causes, ischemic heart disease, and stroke: an ecological study. Prev Med 28, 520529.
56Molloy, AM, Mills, JL, Kirke, PN, et al. . (1999) Folate status and neural tube defects. Biofactors 10, 291294.
57Selhub, J, Bagley, LC, Miller, J, et al. . (2000) B vitamins, homocysteine, and neurocognitive function in the elderly. Am J Clin Nutr 71, 614S620S.
58Rosenberg, IH (2001) B vitamins, homocysteine, and neurocognitive function. Nutr Rev 59, S69S73.
59Balk, EM, Raman, G, Tatsioni, A, et al. . (2007) Vitamin B6, B12, and folic acid supplementation and cognitive function: a systematic review of randomized trials. Arch Intern Med 167, 2130.
60Robinson, K, Arheart, K, Refsum, H, et al. . (1998) Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation 97, 437443.
61Troen, A & Rosenberg, I (2005) Homocysteine and cognitive function. Semin Vasc Med 5, 209214.
62Clarke, R (2008) B vitamins and prevention of dementia. Proc Nutr Soc 67, 7581.
63Bazzano, LA, He, J, Ogden, LG, et al. . (2002) Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-up Study. National Health and Nutrition Examination Survey. Stroke 33, 11831189.
64Albert, CM, Cook, NR, Gaziano, JM, et al. . (2008) Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA 299, 20272036.
65Lonn, E, Yusuf, S, Arnold, MJ, et al. . (2006) Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med 354, 15671577.
66Bønaa, KH, Njølstad, I, Ueland, PM, et al. . (2006) Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med 354, 15781588.
67Beamer, NB, Coull, BM, Press, RD, et al. . (1999) Vitamin use in patients with ischemic stroke. Neurology 52, A64.
68VITATOPS Trial Study Group (2002) The VITATOPS (Vitamins to Prevent Stroke) Trial: rationale and design of an international, large, simple, randomised trial of homocysteine-lowering multivitamin therapy in patients with recent transient ischaemic attack or stroke. Cerebrovasc Dis 13, 120126.
69Spence, JD, Howard, VJ, Chambless, LE, et al. . (2001) Vitamin Intervention for Stroke Prevention (VISP) Trial: rationale and design. Neuroepidemiology 20, 1625.
70Toole, JF, Malinow, MR, Chambless, LE, et al. . (2004) Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction and death. The Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial. JAMA 291, 565575.
71Hankey, GJ & Eikelboom, JW (2004) Folic acid-based multivitamin therapy to prevent stroke: the jury is still out. Stroke 35, 19951998.
72Wald, DS, Law, M & Morris, JK (2002) Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. Br Med J 325, 12021208.
73He, K, Merchant, A, Rimm, EB, et al. . (2004) Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. Stroke 35, 169174.
74Clarke, R & Armitage, J (2000) Vitamin supplements and cardiovascular risk: review of the randomized trials of homocysteine-lowering vitamin supplements. Semin Thromb Hemost 26, 341348.
75Yang, Q, Botto, LD, Erickson, JD, et al. . (2006) Improvement in stroke mortality in Canada and the United States, 1990 to 2002. Circulation 113, 13351343.
76Goldstein, LB (2000) Novel risk factors for stroke: homocysteine, inflammation, and infection. Curr Atheroscler Rep 2, 110114.
77Perry, IJ (1999) Homocysteine, hypertension and stroke. J Hum Hypertens 13, 289293.
78Perry, IJ (1999) Homocysteine and risk of stroke. J Cardiovasc Risk 6, 235240.
79Hankey, GJ (2002) Is homocysteine a causal and treatable risk factor for vascular diseases of the brain (cognitive impairment and stroke)? Ann Neurol 51, 279281.
80Christopher, R, Nagaraja, D & Shankar, SK (2007) Homocysteine and cerebral stroke in developing countries. Curr Med Chem 14, 23932401.
81McNulty, H, Pentieva, K, Hoey, L, et al. . (2008) Homocysteine, B vitamins and CVD. Proc Nutr Soc 67, 232237.
82Cui, RZ, Moriyama, Y, Koike, KA, et al. . (2008) Serum total homocysteine concentrations and risk of mortality from stroke and coronary heart disease in Japanese: the JACC study. Atherosclerosis 198, 412418.
83Ntaios, GC, Savopoulos, CG, Chatzinikolaou, AC, et al. . (2008) Vitamins and stroke: the homocysteine hypothesis still in doubt. Neurologist 14, 24.
84Clarke, R, Armitage, J, Lewington, S, et al. . (2007) Homocysteine-lowering trials for prevention of vascular disease: protocol for a collaborative meta-analysis. Clin Chem Lab Med 45, 15751581.
85Carlsson, CM (2007) Lowering homocysteine for stroke prevention. Lancet 369, 18411842.
86Spence, JD (2006) Homocysteine and stroke prevention: have the trials settled the issue? Int J Stroke 1, 242244.
87Loscalzo, J (2006) Homocysteine trials – clear outcomes for complex reasons. N Engl J Med 354, 16291632.
88Herrmann, W (2001) The importance of hyperhomocysteinemia as a risk factor for diseases: an overview. Clin Chem Lab Med 39, 666674.
89Morris, MS, Jacques, PF, Rosenberg, IH, et al. . (2000) Serum total homocysteine concentration is related to self-reported heart attack or stroke history among men and women in the NHANES III. J Nutr 130, 30733076.
90Kuller, LH & Evans, RW (1998) Homocysteine, vitamins, and cardiovascular disease. Circulation 98, 196199.
91Giles, WH, Croft, JB, Greenlund, KJ, et al. . (1998) Total homocyst(e)ine concentration and the likelihood of nonfatal stroke: results from the Third National Health and Nutrition Examination Survey, 1988–1994. Stroke 29, 24732477.
92Perry, IJ, Refsum, H, Morris, RW, et al. . (1995) Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. Lancet 346, 13951398.
93Verhoef, P, Hennekens, CH, Malinow, MR, et al. . (1994) A prospective study of plasma homocyst(e)ine and risk of ischemic stroke. Stroke 25, 19241930.
94Fallon, UB, Elwood, P, Ben-Shlomo, Y, et al. . (2001) Homocysteine and ischaemic stroke in men: the Caerphilly study. J Epidemiol Community Health 55, 9196.
95Bots, ML, Launer, LJ, Lindemans, J, et al. . (1999) Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 159, 3844.
96Fridman, O (1999) Hyperhomocysteinemia: atherothrombosis and neurotoxicity. Acta Physiol Pharmacol Ther Latinoam 49, 2130.
97Mayer, EL, Jacobsen, DW & Robinson, K (1996) Homocysteine and coronary atherosclerosis. J Am Coll Cardiol 27, 517527.
98Mutus, B, Rabini, RA, Staffolani, R, et al. . (2001) Homocysteine-induced inhibition of nitric oxide production in platelets: a study on healthy and diabetic subjects. Diabetologia 44, 979982.
99Durand, P, Lussier-Cacan, S & Blache, D (1997) Acute methionine load-induced hyperhomocysteinemia enhances platelet aggregation, thromboxane biosynthesis, and macrophage-derived tissue factor activity in rats. FASEB J 11, 11571168.
100Prasad, K (1999) Homocysteine, a risk factor for cardiovascular disease. Int J Angiology 8, 7686.
101Coppola, A, Davi, G, De Stefano, V, et al. . (2000) Homocysteine, coagulation, platelet function, and thrombosis. Semin Thromb Hemost 26, 243254.
102Zhang, G, Zhao, H & Zhang, L (1999) Effects of homocysteine on human vascular endothelial cells, platelet aggregation and heparin cofactor activity (article in Chinese). Zhonghua Xue Ye Xue Za Zhi 20, 471473.
103Hladovec, J, Sommerova, Z & Pisarikova, A (1997) Homocysteinemia and endothelial damage after methionine load. Thromb Res 88, 361364.
104Domagala, TB, Undas, A, Libura, M, et al. . (1998) Pathogenesis of vascular disease in hyperhomocysteinaemia. J Cardiovasc Risk 5, 239247.
105Zhang, C, Cai, Y, Adachi, MT, et al. . (2001) Homocysteine induces programmed cell death in human vascular endothelial cells through activation of the unfolded protein response. J Biol Chem 276, 3586735874.
106Mercié, P, Garnier, O, Lascoste, L, et al. . (2000) Homocysteine-thiolactone induces caspase-independent vascular endothelial cell death with apoptotic features. Apoptosis 5, 403411.
107Wang, H, Yoshizumi, M, Lai, KH, et al. . (1997) Inhibition of growth and p21ras methylation in vascular endothelial cells by homocysteine but not cysteine. J Biol Chem 272, 2538025385.
108Chambers, JC, McGregor, A, Jean-Marie, J, et al. . (1999) Demonstration of rapid onset vascular endothelial dysfunction after hyperhomocysteinemia: an effect reversible with vitamin C therapy. Circulation 99, 11561160.
109Li, H, Lewis, A, Brodsky, S, et al. . (2002) Homocysteine induces 3-hydroxy-3-methylglutaryl coenzyme A reductase in vascular endothelial cells: a mechanism for development of atherosclerosis? Circulation 105, 10371043.
110Kokame, K, Kato, H & Miyata, T (1998) Nonradioactive differential display cloning of genes induced by homocysteine in vascular endothelial cells. Methods 16, 434443.
111SoRelle, R (2002) Inflammation-sensitive proteins: another ingredient in stroke? Circulation 105, e9111.
112Outinen, PA, Sood, SK, Pfeifer, SI, et al. . (1999) Homocysteine-induced endoplasmic reticulum stress and growth arrest leads to specific changes in gene expression in human vascular endothelial cells. Blood 94, 959967.
113Cai, Y, Zhang, C, Nawa, T, et al. . (2000) Homocysteine-responsive ATF3 gene expression in human vascular endothelial cells: activation of c-Jun NH(2)-terminal kinase and promoter response element. Blood 96, 21402148.
114Poddar, R, Sivasubramanian, N, DiBello, PM, et al. . (2001) Homocysteine induces expression and secretion of monocyte chemoattractant protein-1 and interleukin-8 in human aortic endothelial cells: implications for vascular disease. Circulation 103, 27172723.
115Holven, KB, Aukrust, P, Holm, T, et al. . (2002) Folic acid treatment reduces chemokine release from peripheral blood mononuclear cells in hyperhomocysteinemic subjects. Arterioscler Thromb Vasc Biol 22, 699703.
116Wang, G, Siow, YL & O, K (2001) Homocysteine induces monocyte chemoattractant protein-1 expression by activating NF-κB in THP-1 macrophages. Am J Physiol Heart Circ Physiol 280, H2840H2847.
117Desai, A, Lankford, HA & Warren, JS (2001) Homocysteine augments cytokine-induced chemokine expression in human vascular smooth muscle cells: implications for atherogenesis. Inflammation 25, 179186.
118Roth, J, Goebeler, M, Ludwig, S, et al. . (2001) Homocysteine inhibits tumor necrosis factor-induced activation of endothelium via modulation of nuclear factor-κB activity. Biochim Biophys Acta 1540, 154165.
119Cherubini, A, Ruggiero, C, Morand, C, et al. . (2008) Dietary antioxidants as potential pharmacological agents for ischemic stroke. Curr Med Chem 15, 12361248.
120Moats, C & Rimm, EB (2007) Vitamin intake and risk of coronary disease: observation versus intervention. Curr Atheroscler Rep 9, 508514.
121Thomas, DR (2006) Vitamins in aging, health, and longevity. Clin Intervent Aging 1, 8191.
122Arria, AM, Tarter, RE, Warty, V, et al. . (1990) Vitamin E deficiency and psychomotor dysfunction in adults with primary biliary cirrhosis. Am J Clin Nutr 52, 383390.
123Shorer, Z, Parvari, R, Bril, G, et al. . (1996) Ataxia with isolated vitamin E deficiency in four siblings. Pediatr Neurol 15, 340343.
124Behl, C (1999) Vitamin E and other antioxidants in neuroprotection. Int J Vitam Nutr Res 69, 213219.
125Launer, LJ & Kalmijn, S (1998) Anti-oxidants and cognitive function: a review of clinical and epidemiologic studies. J Neural Transm Suppl 53, 18.
126Perkins, AJ, Hendrie, HC, Callahan, CM, et al. . (1999) Association of antioxidants with memory in a multiethnic elderly sample using the Third National Health and Nutrition Examination Survey. Am J Epidemiol 150, 3744.
127Schmidt, R, Hayn, M, Reinhart, B, et al. . (1998) Plasma antioxidants and cognitive performance in middle-aged and older adults: results of the Austrian Stroke Prevention study. J Am Geriatr Soc 46, 14071410.
128Rosenblum, WI, Nelson, GH, Bei, RA, et al. . (1996) Vitamin E ameliorates adverse effects of endothelial injury in brain arterioles. Am J Physiol Heart Circul Physiol 40, H637H642.
129Leppälä, JM, Virtamo, J, Fogelholm, R, et al. . (2000) Controlled trial of α-tocopherol and β-carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vasc Biol 20, 230235.
130Benson, RT (1999) Vitamin E supplementation lowers risk for ischemic stroke. 51st Annual Meeting of the American Academy of Neurology. Toronto, Canada.
131Devaraj, S & Jialal, I (2000) α Tocopherol supplementation decreases serum C-reactive protein and monocyte interleukin-6 levels in normal volunteers and type 2 diabetic patients. Free Radic Biol Med 29, 790792.
132Hodis, HN, Mack, WJ, LaBree, LD, et al. . (2002) α-Tocopherol supplementation in healthy individuals reduces low-density lipoprotein oxidation but not atherosclerosis: the Vitamin E Atherosclerosis Prevention Study (VEAPS). Circulation 106, 14531459.
133Bunout, D (2000) Therapeutic potential of vitamin E in heart disease. Expert Opin Investig Drugs 9, 26292635.
134Dagenais, GR, Marchioli, R, Yusuf, S, et al. . (2000) β-Carotene, vitamin C, and vitamin E and cardiovascular diseases. Curr Cardiol Rep 2, 293299.
135Lonn, E (2005) Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 293, 13381347.
136Miller, ER III, Pastor-Barriuso, R, Dalal, D, et al. . (2005) Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Inter Med 142, 3746.
137Grzegorczyk, K, Rutkowski, M & Drozda, R (2001) Vitamin C in treatment of certain cardiovascular diseases. Pol Merkur Lekarski 10, 122125.
138Foy, CJ, Passmore, AP, Vahidassr, MD, et al. . (1999) Plasma chain-breaking antioxidants in Alzheimer's disease, vascular dementia and Parkinson's disease. Q J Med 92, 3945.
139Frei, B. (ed.). (1994) Natural Antioxidants in Human Health and Disease. San Diego, CA: Academic Press.
140Simon, JA, Hudes, ES & Browner, WS (1998) Serum ascorbic acid and cardiovascular disease prevalence in U.S. adults. Epidemiolology 9, 316321.
141Ness, AR, Powles, JW & Khaw, KT (1996) Vitamin C and cardiovascular disease: a systematic review. J Cardiovasc Risk 3, 513521.
142Sano, M, Ernesto, C, Thomas, RG, et al. . (1997) A controlled trial of selegiline, α-tocopherol, or both as treatment for Alzheimer's disease. N Engl J Med 336, 12161222.
143Padh, H (1991) Vitamin C: newer insights into its biochemical functions. Nutr Rev 49, 6570.
144Sato, K, Saito, H & Katsuki, H (1993) Synergism of tocopherol and ascorbate on the survival of cultured brain neurones. Neuroreport 4, 11791182.
145Kurl, S, Tuomainen, TP, Laukkanen, JA, et al. . (2002) Plasma vitamin C modifies the association between hypertension and risk of stroke. Stroke 33, 15681573.
146Myint, PK, Luben, RN, Welch, AA, et al. . (2008) Plasma vitamin C concentrations predict risk of incident stroke over 10 y in 20 649 participants of the European Prospective Investigation into Cancer-Norfolk prospective population study. Am J Clin Nutr 87, 6469.
147Joshipura, KJ, Ascherio, A, Manson, JE, et al. . (1999) Fruit and vegetable intake in relation to risk of ischemic stroke. JAMA 282, 12331239.
148Cook, NR, Albert, CM, Gaziano, JM, et al. . (2007) A randomized factorial trial of vitamins C and E and β carotene in the secondary prevention of cardiovascular events in women: results from the Women's Antioxidant Cardiovascular Study. Arch Int Med 167, 16101618.
149Ullegaddi, R, Powers, HJ & Gariballa, SE (2005) Antioxidant supplementation enhances antioxidant capacity and mitigates oxidative damage following acute ischaemic stroke. Eur J Clin Nutr 59, 13671373.
150Ungvari, Z, Buffenstein, R, Austad, SN, et al. . (2008) Oxidative stress in vascular senescence: lessons from successfully aging species. Front Biosci 13, 50565070.
151Allen, CL & Bayraktutan, U (2008) Risk factors for ischaemic stroke. Int J Stroke 3, 105116.
152Taffi, R, Nanetti, L, Mazzanti, L, et al. . (2008) Plasma levels of nitric oxide and stroke outcome. J Neurol 255, 9498.
153Ferretti, G, Bacchetti, T, Masciangelo, S, et al. . (2008) Lipid peroxidation in stroke patients. Clin Chem Lab Med 46, 113117.
154Seneş, M, Kazan, N, Coşkun, Ö, et al. . (2007) Oxidative and nitrosative stress in acute ischaemic stroke. Ann Clin Biochem 44, 4347.
155Mariani, E, Polidori, MC, Cherubini, A, et al. . (2005) Oxidative stress in brain aging, neurodegenerative and vascular diseases: an overview. J Chromatogr B 827, 6575.
156Cherubini, A, Ruggiero, C, Polidori, MC, et al. . (2005) Potential markers of oxidative stress in stroke. Free Radic Biol Med 39, 841852.
157Polidori, MC, Frei, B, Cherubini, A, et al. . (1998) Increased plasma levels of lipid hydroperoxides in patients with ischemic stroke. Free Radic Biol Med 25, 561567.
158Cherubini, A, Polidori, MC, Bregnocchi, M, et al. . (2000) Antioxidant profile and early outcome in stroke patients. Stroke 31, 22952300.
159Pratico, D, Lee, VMY, Trojanowski, JQ, et al. . (1998) Increased F2-isoprostanes in Alzheimer's disease: evidence for enhanced lipid peroxidation in vivo. FASEB J 12, 17771783.
160May, JM, Qu, ZC, Morrow, JD, et al. . (2000) Ascorbate-dependent protection of human erythrocytes against oxidant stress generated by extracellular diazobenzene sulfonate. Biochem Pharmacol 60, 4753.
161Kelly, PJ, Morrow, JD, Ning, M, et al. . (2008) Oxidative stress and matrix metalloproteinase-9 in acute ischemic stroke: The Biomarker Evaluation for Antioxidant Therapies in Stroke (BEAT-Stroke) study. Stroke 39, 100104.
162Sánchez-Moreno, C, Dashe, JF, Scott, T, et al. . (2004) Decreased levels of plasma vitamin C and increased concentrations of inflammatory and oxidative stress markers after stroke. Stroke 35, 163168.
163Ozkul, A, Akyol, A, Yenisey, C, et al. . (2007) Oxidative stress in acute ischemic stroke. J Clin Neurosci 14, 10621066.
164Bonithon-Kopp, C, Coudray, C, Berr, C, et al. . (1997) Combined effects of lipid peroxidation and antioxidant status on carotid atherosclerosis in a population aged 59–71 y: The EVA Study. Etude sur le Vieillisement Arteriel. Am J Clin Nutr 65, 121127.
165Yoo, JH & Lee, SC (2001) Elevated levels of plasma homocyst(e)ine and asymmetric dimethylarginine in elderly patients with stroke. Atherosclerosis 158, 425430.
166Iso, H (2005) Homocysteine and increased risk of stroke. Cardiol Rev 22, 2629.
167Keli, SO, Hertog, MG, Feskens, EJ, et al. . (1996) Dietary flavonoids, antioxidant vitamins, and incidence of stroke: the Zutphen study. Arch Intern Med 156, 637642.
168Daviglus, ML, Orencia, AJ, Dyer, AR, et al. . (1997) Dietary vitamin C, β-carotene and 30-year risk of stroke: results from the Western Electric Study. Neuroepidemiology 16, 6977.
169Hirvonen, T, Virtamo, J, Korhonen, P, et al. . (2000) Intake of flavonoids, carotenoids, vitamins C and E, and risk of stroke in male smokers. Stroke 31, 23012306.
170Yokoyama, T, Date, C, Kokubo, Y, et al. . (2000) Serum vitamin C concentration was inversely associated with subsequent 20-year incidence of stroke in a Japanese rural community. The Shibata study. Stroke 31, 22872294.
171Polidori, MC, Mecocci, P & Frei, B (2001) Plasma vitamin C levels are decreased and correlated with brain damage in patients with intracranial hemorrhage or head trauma. Stroke 32, 898902.
172Vokó, Z, Hollander, M, Hofman, A, et al. . (2003) Dietary antioxidants and the risk of ischemic stroke: The Rotterdam Study. Neurology 61, 12731275.
173Benson, RT, Jacobs, B, Boden-Albala, B, et al. . (1999) Vitamin E intake: a primary preventive measure in stroke. Neurology 52, A146.
174Vatassery, GT, Bauer, T & Dysken, M (1999) High doses of vitamin E in the treatment of disorders of the central nervous system in the aged. Am J Clin Nutr 70, 793801.
175Suter, PM (2000) Effect of vitamin E, vitamin C, and β-carotene on stroke risk. Nutr Rev 58, 184187.

Keywords

Related content

Powered by UNSILO

Stroke: roles of B vitamins, homocysteine and antioxidants

  • Concepción Sánchez-Moreno (a1), Antonio Jiménez-Escrig (a2) and Antonio Martín (a3)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.