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Postintervention effect of alpha tocopherol and beta carotene on different strokes: a 6-year follow-up of the Alpha Tocopherol, Beta Carotene Cancer Prevention Study.

Abstract

BACKGROUND AND PURPOSE

In the Alpha Tocopherol, Beta Carotene Cancer Prevention Study, alpha tocopherol supplementation decreased risk of cerebral infarction by 14% (95% CI, -25% to -1%), and beta carotene increased risk of intracerebral hemorrhage by 62% (95% CI, 10% to 132%). We report here the 6-year postintervention effects of alpha tocopherol and beta carotene supplementation on stroke and its subtypes.

METHODS

A total of 29,133 male smokers, aged 50 to 69 years, were randomized to receive 50 mg of alpha tocopherol, 20 mg of beta carotene, both, or placebo daily for 5 to 8 years. At the beginning of the post-trial follow-up, 24 382 men were still at risk for first-ever stroke. During the post-trial follow-up, 1327 men experienced a stroke: 1087 cerebral infarctions, 148 intracerebral hemorrhages, 64 subarachnoid hemorrhages, and 28 unspecified strokes.

RESULTS

Post-trial risk for cerebral infarction was elevated among those who had received alpha tocopherol compared with those who had not (relative risk [RR], 1.13; 95% CI, 1.00 to 1.27), whereas beta carotene had no effect (RR, 0.97; 95% CI, 0.86 to 1.09). Alpha tocopherol supplementation was associated with a postintervention RR of 1.01 (95% CI, 0.73 to 1.39) for intracerebral hemorrhage and 1.38 (95% CI, 0.84 to 2.26) for subarachnoid hemorrhage. The corresponding RRs associated with beta carotene supplementation were 1.38 (95% CI, 0.99 to 1.91) and 1.09 (95% CI, 0.67 to 1.77), respectively.

CONCLUSIONS

Neither alpha tocopherol nor beta carotene supplementation had any postintervention preventive effects on stroke. The post-trial increase in cerebral infarction risk among recipients of alpha tocopherol may present a rebound of the reduced risk of cerebral infarction during the intervention.

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  • Authors+Show Affiliations

    ,

    National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 166, 00300 Helsinki, Finland. markareetta.tornwall@ktl.fi

    , , , ,

    Source

    Stroke 35:8 2004 Aug pg 1908-13

    MeSH

    Antioxidants
    Cerebral Hemorrhage
    Cerebral Infarction
    Dietary Supplements
    Follow-Up Studies
    Humans
    Lung Neoplasms
    Male
    Middle Aged
    Randomized Controlled Trials as Topic
    Risk
    Smoking
    Stroke
    Subarachnoid Hemorrhage
    alpha-Tocopherol
    beta Carotene

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15205487

    Citation

    Törnwall, Markareetta E., et al. "Postintervention Effect of Alpha Tocopherol and Beta Carotene On Different Strokes: a 6-year Follow-up of the Alpha Tocopherol, Beta Carotene Cancer Prevention Study." Stroke, vol. 35, no. 8, 2004, pp. 1908-13.
    Törnwall ME, Virtamo J, Korhonen PA, et al. Postintervention effect of alpha tocopherol and beta carotene on different strokes: a 6-year follow-up of the Alpha Tocopherol, Beta Carotene Cancer Prevention Study. Stroke. 2004;35(8):1908-13.
    Törnwall, M. E., Virtamo, J., Korhonen, P. A., Virtanen, M. J., Albanes, D., & Huttunen, J. K. (2004). Postintervention effect of alpha tocopherol and beta carotene on different strokes: a 6-year follow-up of the Alpha Tocopherol, Beta Carotene Cancer Prevention Study. Stroke, 35(8), pp. 1908-13.
    Törnwall ME, et al. Postintervention Effect of Alpha Tocopherol and Beta Carotene On Different Strokes: a 6-year Follow-up of the Alpha Tocopherol, Beta Carotene Cancer Prevention Study. Stroke. 2004;35(8):1908-13. PubMed PMID: 15205487.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Postintervention effect of alpha tocopherol and beta carotene on different strokes: a 6-year follow-up of the Alpha Tocopherol, Beta Carotene Cancer Prevention Study. AU - Törnwall,Markareetta E, AU - Virtamo,Jarmo, AU - Korhonen,Pasi A, AU - Virtanen,Mikko J, AU - Albanes,Demetrius, AU - Huttunen,Jussi K, Y1 - 2004/06/17/ PY - 2004/6/19/pubmed PY - 2004/12/24/medline PY - 2004/6/19/entrez SP - 1908 EP - 13 JF - Stroke JO - Stroke VL - 35 IS - 8 N2 - BACKGROUND AND PURPOSE: In the Alpha Tocopherol, Beta Carotene Cancer Prevention Study, alpha tocopherol supplementation decreased risk of cerebral infarction by 14% (95% CI, -25% to -1%), and beta carotene increased risk of intracerebral hemorrhage by 62% (95% CI, 10% to 132%). We report here the 6-year postintervention effects of alpha tocopherol and beta carotene supplementation on stroke and its subtypes. METHODS: A total of 29,133 male smokers, aged 50 to 69 years, were randomized to receive 50 mg of alpha tocopherol, 20 mg of beta carotene, both, or placebo daily for 5 to 8 years. At the beginning of the post-trial follow-up, 24 382 men were still at risk for first-ever stroke. During the post-trial follow-up, 1327 men experienced a stroke: 1087 cerebral infarctions, 148 intracerebral hemorrhages, 64 subarachnoid hemorrhages, and 28 unspecified strokes. RESULTS: Post-trial risk for cerebral infarction was elevated among those who had received alpha tocopherol compared with those who had not (relative risk [RR], 1.13; 95% CI, 1.00 to 1.27), whereas beta carotene had no effect (RR, 0.97; 95% CI, 0.86 to 1.09). Alpha tocopherol supplementation was associated with a postintervention RR of 1.01 (95% CI, 0.73 to 1.39) for intracerebral hemorrhage and 1.38 (95% CI, 0.84 to 2.26) for subarachnoid hemorrhage. The corresponding RRs associated with beta carotene supplementation were 1.38 (95% CI, 0.99 to 1.91) and 1.09 (95% CI, 0.67 to 1.77), respectively. CONCLUSIONS: Neither alpha tocopherol nor beta carotene supplementation had any postintervention preventive effects on stroke. The post-trial increase in cerebral infarction risk among recipients of alpha tocopherol may present a rebound of the reduced risk of cerebral infarction during the intervention. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/15205487/Postintervention_effect_of_alpha_tocopherol_and_beta_carotene_on_different_strokes:_a_6_year_follow_up_of_the_Alpha_Tocopherol_Beta_Carotene_Cancer_Prevention_Study_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.STR.0000131750.60270.42?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -