期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 115, 期 1, 页码 222-231出版社
ELSEVIER SCIENCE INC
DOI: 10.1093/ajcn/nqab320
关键词
selenium; first stroke; hypertension; folate; systolic blood pressure; risk factor
资金
- National Key Research and Development Program [2016YFE0205400, 2018ZX09739010, 2018ZX09301034003]
- Science and Technology Planning Project of Guangzhou, China [201707020010]
- Science, Technology and Innovation Committee of Shenzhen [GJHS20170314114526143, JSGG20180703155802047]
- Economic, Trade and Information Commission of Shenzhen Municipality [20170505161556110, 20170505160926390, 201705051617070]
- National Natural Science Foundation of China [81730019, 81973133, 82000691, 81960074]
- President Foundation of Nanfang Hospital, Southern Medical University [2018Z009]
- Outstanding Youth Development Scheme of Nanfang Hospital, Southern Medical University [2019J004]
- 111 Project from the Education Ministry of China [B18053]
- Jiangxi Outstanding Person Foundation [20192BCBL23024]
The secondary analysis of the China Stroke Primary Prevention Trial (CSPPT) revealed a significant inverse association between plasma selenium and risk of first stroke in Chinese adults with hypertension, especially among those with higher baseline folate concentrations and those with higher time-averaged systolic blood pressure over the treatment period.
Background: Previous studies have indicated that selenium (Se) may play an important role in cardio-cerebrovascular disease. However, the relation between circulating selenium and risk of first stroke remains inconclusive. Objectives: We conducted a secondary analysis of the China Stroke Primary Prevention Trial (CSPPT), using a nested case-control design, and aimed to investigate the correlation between Se concentration and first stroke risk in adults with hypertension and examine the potential effect modifiers. Methods: In the CSPPT, a total of 20,702 adults with hypertension 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. A total of 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site were included in this study. Results: During a median follow-up duration of 4.5 y (IQR: 4.2-4.6 y), there was a significant inverse association between plasma Se and the risk of first stroke (per SD increment; adjusted OR: 0.81; 95% CI: 0.68, 0.96) and ischemic stroke (per SD increment; adjusted OR: 0.76; 95% CI: 0.62, 0.93). Furthermore, a stronger inverse association between plasma Se and first stroke was observed in participants with higher folate concentrations at baseline [>= 7.7 ng/mL (median), adjusted OR: 0.67; 95% CI: 0.54, 0.85, compared with <7.7 ng/mL, adjusted OR: 0.98; 95% CI: 0.80, 1.21; Pinteraction = 0.008] and those with higher time-averaged systolic blood pressure (SBP) over the treatment period (>= 140 mm Hg, adjusted OR: 0.71; 95% CI: 0.58, 0.86, compared with <140 mm Hg, adjusted OR: 0.96; 95% CI: 0.77, 1.20; P-interaction = 0.023). Conclusions: There was a significant inverse association between plasma Se and risk of first stroke in Chinese adults with hypertension, especially among those with higher baseline folate concentrations and those with higher time-averaged SBP over the treatment period.
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