Plasma retinol and the risk of first stroke in hypertensive adults: A nested case-control study

Yaren Yu, Hao Zhang, Yun Song, Tengfei Lin, Ziyi Zhou, Huiyuan Guo, Lishun Liu, Binyan Wang, Chengzhang Liu, Jianping Li, Yan Zhang, Yong Huo, Chaofu Wang, Xiaobin Wang, Fan Fan Hou, Xianhui Qin, Xiping Xu

Research output: Contribution to journalArticle

Abstract

Background Identification of novel risk factors is needed to further lower stroke risk. Data concerning the association between plasma retinol concentrations and the risk of stroke are limited. Objectives We aimed to evaluate the effect of plasma retinol on the risk of first stroke and to examine any possible effect modifiers in hypertensive patients. Methods The study sample population was drawn from the China Stroke Primary Prevention Trial (CSPPT), using a nested case-control design, including 620 cases with first stroke and 620 matched controls. In the CSPPT, a total of 20,702 hypertensive patients were randomly assigned to a double-blind, daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. The median treatment duration was 4.5 y. Results There was a significant inverse association between plasma retinol and the risk of first stroke (per 10-μg/dL increment; OR: 0.92; 95% CI: 0.86, 0.97) and first ischemic stroke (OR: 0.92; 95% CI: 0.86, 0.98). When retinol was assessed as quartiles, significantly lower risks of first stroke (OR: 0.64; 95% CI: 0.46, 0.88) and first ischemic stroke (OR: 0.67; 95% CI: 0.46, 0.96) were found in participants in quartiles 2-4 compared with those in quartile 1. Furthermore, a stronger inverse association between plasma retinol and first stroke was observed in participants with baseline total homocysteine (<10 compared with ≥10 μmol/L; P-interaction = 0.049). However, plasma retinol had no significant effect on first hemorrhagic stroke (per 10-μg/dL increment; OR: 0.98; 95% CI: 0.79, 1.18). Conclusions Our data showed a significant inverse association between plasma retinol and the risk of first stroke among Chinese hypertensive adults. This study was registered at clinicaltrials.gov as NCT00794885.

Original languageEnglish (US)
Pages (from-to)449-456
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Volume109
Issue number2
DOIs
StatePublished - Feb 1 2019

Keywords

  • first stroke
  • hypertension; cardiovascular disease
  • retinol
  • total homocysteine

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Fingerprint Dive into the research topics of 'Plasma retinol and the risk of first stroke in hypertensive adults: A nested case-control study'. Together they form a unique fingerprint.

  • Cite this

    Yu, Y., Zhang, H., Song, Y., Lin, T., Zhou, Z., Guo, H., Liu, L., Wang, B., Liu, C., Li, J., Zhang, Y., Huo, Y., Wang, C., Wang, X., Hou, F. F., Qin, X., & Xu, X. (2019). Plasma retinol and the risk of first stroke in hypertensive adults: A nested case-control study. American Journal of Clinical Nutrition, 109(2), 449-456. https://doi.org/10.1093/ajcn/nqy320