Overview Stroke and vitamin D

Summary - as with many other diseases,

• 2000+ IU of vitamin D will provide some stroke prevention
• 10,000+ IU of vitamin D will provide some treatment and prevention
• need more if in a high risk group
  • examples include elderly, dark skin, live from from equator, obese, avoid the sun, ...

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Stroke mortality 3X worse among seniors with less than 26 ng of vitamin D – June 2014

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See also at VitaminDWiki

• Second stroke 2X more likely if low vitamin D – Feb 2015
• Following a stroke, 10 ng less vitamin D associated with 2X more white matter hyperintensities – Nov 2014
• All items in Stroke and vitamin D 34 items
• Cerebrovascular disease 40 percent less likely if high level of vitamin D – meta-analysis Sept 2012
• Twice as many fatal strokes among whites who were low on vitamin D – Jan 2012
• Stroke 50 % more likely if low vitamin D – meta-analysis March 2012
• Vitamin D associated with 50 percent less ischemic stroke – meta-analysis Aug 2012
• Strokes might be treated as well as prevented by vitamin D – Jan 2011
• Cardiology diseases highly associated with low vitamin D – Oct 2010 less than 30 ng/ml
• Question - Does more vitamin D make veins less stiff Nov 2007
• Heart disease, stroke, ...all linked to insufficient vitamin D levels LEF 2009 75% more likely to have a stroke
• Stroke patients show dearth of vitamin D – 2005
• CLICK HERE to use Google Site Search for STROKE
• Too much and too little Calcium both increase death after strokes – Jan 2011
• Calcium without vitamin D increased heart risk by 30 percent - Jan 2011 and stroke by 20%
• Overview Cardiovascular and vitamin D
• Meta-analysis found hypertension reduced with vitamin D – Dec 2010
• Hypertension and vitamin D many articles
• All items in category Hypertension and Vitamin D 64 items
• Metabolic Syndrome and vitamin D
• Stroke patients show dearth of vitamin D – 2005
• Following a stroke, a hip fracture is 6X more likely if low vitamin D – July 2001
• Vitamin D reduced blood pressure in random controlled trials – Nov 2010
• Hypothesis that lack of vitamin D increases blood pressure in blacks – July 2010
• 80 percent recent increase in Strokes following pregnancy - July 2011
• Lack of vitamin D closely associated with black health disparities – Nov 2010 example: Blacks are 50% more likely to die of strokes
  • 0.4 year of the 5 year life penalty for having black skin = fatal stroke
• Fewer white spots in MRI brain scans if had more vitamin D – Jan 2014 white spots on MRI increase by 3.5X of getting a stroke

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Depression lead to Strokes (VitaminDWiki notes that both are related to low vitamin D)

Article about Brigham Women's Hospital Study which was published in Stroke
"women with a history of depression had a 29 percent higher risk of stroke, even after considering other stroke risk factors."
"The study included more than 80,000 female nurses between the ages of 54 to 79 years old from 2000-06 without a prior history of stroke. "
"More than 1000 cases of stroke were documented among the women during the six years."
CLICK HERE for abstract Aug 2011
(VitaminDWiki notices that the principal author has published many other papers on cardiovascular problems and low vitamin D levels. Kathryn M. Rexrode krexrode at partners.org)

See also VitaminDWiki No longer depressed, but risk of stroke is still 1.7X higher (did not consider low vitamin D) – May 2015

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Stroke Incidence Increasing Among Children And Young Adults, USA Medical News today, Sept 2011

In Annals of Neurology., researchers found that over the period 1995-1996 to 2007-2008:
Ischemic stroke incidence rose 50% among males aged 35 to 44 years
Ischemic stroke incidence rose 46% among males aged 15 to 34.
Ischemic stroke incidence rose 51% among boys aged 5 to 14.
no mention of vitamin D

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Rising Incidence of Stroke Among Young Adults

Reporting on Christine Fox, MD, MAS reviewing Kissela BM et al. Neurology 2012 Oct 23.
The stroke incidence among adults aged 20 to 54 increased substantially during a 12-year period in a population-based study.
For aged 20 through 54 from 1993–1994 ==> 2005 incidence rate per 100,000

• Blacks 83 ==> 128
• Whites 26 ==> 48

no mention of vitamin D

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New Study Shows Lack of this Vitamin Linked to Strokes Mercola Jan 2011

comment on American Heart Association's (AHA) Annual Scientific Sessions, Chicago, IL November 15, 2010
clip - - - -
Not only is vitamin D known to help reduce your risk of arterial stiffness, a major risk factor for stroke, but it can also:

• Increase in your body's natural anti-inflammatory cytokines
• Suppress vascular calcification
• Inhibit vascular smooth muscle growth

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Hypertension (blood pressure) increases incidence of strokes

• Overview Hypertension and vitamin D at VitaminDWki
• About.com
  70% of strokes related to high blood pressure
  "high blood pressure the single most important controllable stroke risk factor, especially in the elderly."

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Stroke patients with low vitamin D were 10X more likely to become depressed – Aug 2014

Stroke patients with low vitamin D were 10X more likely to become depressed – Aug 2014

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Strokes occur 25% more often in the Spring - when the vitamin D blood levels are the lowest

Incidence of Stroke and Season of the Year: Evidence of an Association
Am J Epidemiol 2000;152:558–64.
1. Ann L. Oberg 1 , 2 , 3 ,
2. Jeffery A. Ferguson 4 , 5 ,
3. Lauren M. McIntyre 2 , 6 , 7 , 8 and
4. Ronnie D. Horner 2 , 6 , 9

Evidence of seasonal variation in the incidence of stroke is inconsistent. This may be a likely consequence of one or more methodological shortcomings of the studies investigating this issue, including inappropriate analytic models, insufficient length of time, small sample size, and a regional (vs. national) focus. The authors' objective was to ascertain whether an association exists between season of the year and the incidence of stroke by using a methodological approach designed to overcome these limitations.
The authors used a longitudinal study design involving 72,779 veterans hospitalized for stroke at any Veterans Affairs hospital nationally during the years 1986–1995.
These data were analyzed by using time series methods.
There was clear evidence of a seasonal occurrence for stroke in general.
This seasonal effect was found for ischemic stroke, but not for hemorrhagic stroke.
The peak occurrence was in mid-May.
Neither the region (i.e., climate) nor the race of the patient substantially modified the seasonal trend. An explanation for this pattern remains to be determined.

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Chart from a 2010 Vitamin D book edited by Dr. Holick

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BBC Sept 2011 30% Increase of strokes among young in the US Vit D not mentioned

• The rate of ischemic stroke increased by 31% in five to 14-year-olds, from 3.2 strokes per 10,000 hospital cases to 4.2 per 10,000.
• There were increases of 30% for people aged 15 to 34 and 37% in patients between the ages of 35 and 44.
• More than half of 35 to 44-year-olds who had an ischemic stroke also had hypertension.

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Strokes in younger people worldwide 'worrying' CBC News Oct 2013

Lancet article
The commentators also called the the global increase of of 25 per cent in the incidence of stroke in those aged 25 to 64 "a worrying finding."

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Magnesium in water also associated with reduction in stroke

100 mg more Magnesium in water associated with 8 percent reduction in stroke – Feb 2012
Independent evidence shows that Vitamin D and Magnesium both reduce strokes.
Expect that they would do well together - perhaps more than 2X the benefit

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Stroke 50 % more likely if low vitamin D - Meta-analysis May 2012

25-Hydroxyvitamin D Levels and the Risk of Stroke. A Prospective Study and Meta-analysis
Qi Sun, MD, ScD qisun at hsph.harvard.edu ; An Pan, PhD; Frank B. Hu, MD, PhD; JoAnn E. Manson, MD, DrPH; Kathryn M. Rexrode, MD, MPH
From the Departments of Nutrition (Q.S., A.P., F.B.H.) and Epidemiology (F.B.H., J.E.M.), Harvard School of Public Health, Boston, MA; and the Channing Laboratory (Q.S., F.B.H., J.E.M.) and the Division of Preventive Medicine (J.E.M., K.M.R.), the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Background and Purpose—Despite evidence suggesting that vitamin D deficiency may lead to elevated cardiovascular disease risk, results regarding the association of 25-hydroxyvitamin D (25OHD) levels with stroke risk are inconclusive. We aimed to examine this association in a prospective study in women and to summarize all existing data in a meta-analysis.

Methods—We measured 25(OH)D levels among 464 women who developed ischemic stroke and an equal number of control subjects who were free of stroke through 2006 in the Nurses' Health Study (NHS). We searched MEDLINE and EMBASE for articles published through March 2011 that prospectively evaluated 25(OH)D levels in relation to stroke.

Results—After multivariable adjustment for lifestyle and dietary covariates, lower 25(OH)D levels were associated with an elevated risk of ischemic stroke in the NHS: the OR (95% CI) comparing women in the lowest versus highest tertiles was 1.49 (1.01–2.18; Ptrend=0.04). We found 6 other prospective studies that examined 25(OH)D in relation to stroke outcomes. After pooling our results with these prospective studies that included 1214 stroke cases in total, low 25(OH)D levels were associated with increased risk of developing stroke outcomes in comparison to high levels: the pooled relative risk (95% CI) was 1.52 (1.20–1.85; I2=0.0%, Pheterogeneity=0.63). In 2 studies that explicitly examined ischemic stroke, this association was 1.59 (1.07–2.12; I2=0.0%, Pheterogeneity=0.80).

Conclusions—These data provide evidence that low vitamin D levels are modestly associated with risk of stroke.
Maintaining adequate vitamin D status may lower the risk of stroke in women.

Received August 22, 2011; Revision received January 24, 2012; Accepted February 9, 2012.

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VitaminDWiki studies which are Stroke Meta-analysis

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4X more likely to survive stroke if have high vitamin D level - May 2014

Prognostic Value of Serum 25-Hydroxyvitamin D in Patients with Stroke.
Neurochem Res. 2014 May 1. [Epub ahead of print]
Wang Y1, Ji H, Tong Y, Zhang ZB.
Author information
Abstract
We aimed to evaluate the association between 25-hydroxyvitamin D [25(OH) D] levels and both clinical severity at admission and outcome at discharge in patients with acute ischemic stroke (AIS). From June 2012 to October 2013, consecutive first-ever AIS patients admitted to the Department of Emergency of The Fourth Affiliated Hospital of Harbin Medical University, China were identified. Clinical information was collected. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome was evaluated at discharge using the modified Rankin scale (m-Rankin). Multivariate analyses were performed using logistic regression models. During the study period, 326 patients were diagnosed as AIS and were included in the analysis. Serum 25(OH) D levels reduced with increasing severity of stroke as defined by the NIHSS score. There was a negative correlation between levels of 25(OH) D and the NIHSS (r = - 0.389, P = 0.000). In multivariate analyses, serum 25(OH) D level was an independent prognostic marker of discharge favorable functional outcome and survival [odds ratio 3.96 (2.85-7.87) and 3.36 (2.12-7.08), respectively, P = 0.000 for both, adjusted for NHISS, other predictors and vascular risk factors] in patients with AIS. Serum 25(OH) D levels are a predictor of both severity at admission and favorable functional outcome in patients with AIS. Additional research is needed on vitamin D supplementation to improve the outcome of post-stroke patients.
PMID: 24789365