Low Dietary Vitamin D Predicts 34-Year Incident Stroke The Honolulu Heart Program

• Published in: Stroke (1970) Vol. 43; no. 8; pp. 2163 - 2167
• Main Authors: KOJIMA, Gotaro, BELL, Christina, ABBOTT, Robert D, LAUNER, Lenore, CHEN, Randi, MOTONAGA, Heather, WEBSTER ROSS, G, DAVID CURB, J, MASAKI, Kamal
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.08.2012
• Subjects: Age Factors; Aged; Analysis of Variance; Asian Americans - statistics & numerical data; Biological and medical sciences; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - epidemiology; Cohort Studies; Diet; Diet Surveys; Hawaii - epidemiology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Longitudinal Studies; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Prospective Studies; Regression Analysis; Risk Factors; Stroke - epidemiology; Stroke - etiology; Thromboembolism - complications; Thromboembolism - epidemiology; Vascular diseases and vascular malformations of the nervous system; Vitamin D; Hawaii; Human; Stroke; Nervous system diseases; Japanese-American men; Cardiovascular disease; incident stroke; Japanese; Cerebral disorder; Vascular disease; Vitamin D; Cohort study; Central nervous system disease; longitudinal cohort study; Cerebrovascular disease; dietary vitamin D intake
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.112.651752

Vitamin D deficiency has been reported to contribute to the risk of cardiovascular disease, especially stroke. We examined the relationship between dietary vitamin D intake and 34-year incident stroke. The Honolulu Heart Program is a prospective population-based cohort study of 8006 Japanese-American men in Hawaii who were 45 to 68 years old at the baseline examination in 1965 to 1968. Dietary vitamin D intake was calculated using the Nutritionist IV Version 3 software from a 24-hour dietary recall. Subjects with prevalent stroke were excluded, leaving 7385 men followed through 1999 for incident stroke. Subjects were divided into quartiles of dietary vitamin D for analyses. During 34 years of follow-up, 960 subjects developed stroke. Age-adjusted rates of incident stroke were significantly higher in the lowest dietary vitamin D quartile compared with the highest (all stroke: 6.38 versus 5.14 per 1000 person-years follow-up, P=0.030; thromboembolic stroke: 4.36 versus 3.30, P=0.033). Using Cox regression, adjusting for age, total kilocalories, body mass index, hypertension, diabetes mellitus, pack-years smoking, physical activity index, serum cholesterol, and alcohol intake, those in the lowest quartile had a significantly increased risk of incident stroke (all stroke hazard ratio, 1.22; 95% CI, 1.01-1.47; P=0.038; thromboembolic stroke hazard ratio, 1.27; 95% CI, 1.01-1.59; P=0.044) with the highest as the reference. We found no significant associations between dietary vitamin D and hemorrhagic stroke. Low dietary vitamin D intake was an independent risk factor for 34-year incidence of all stroke and thromboembolic stroke in Japanese-American men. Additional research is needed on vitamin D supplementation to prevent stroke.