An article published online on March 11, 2011 in the American Heart Association journal Stroke reveals the results of a large study of Swedish women which found a lower risk of stroke in those who consumed coffee.
Susanna Larsson, PhD, of the Division of Nutritional Epidemiology at the Karolinska Institute's National Institute of Environmental Medicine and her associates evaluated data from 34,670 women aged 49 to 83 enrolled in the Swedish Mammography Cohort, which was designed to investigate the association between disease development, diet and lifestyle. Food questionnaires completed upon enrollment in 1997 were used to determine the number of daily cups of coffee consumed. The women were followed for ten years, during which 1,310 ischemic strokes (cerebral infarction), 154 intracerebral hemorrhages, 79 subarachnoid hemorrhages (characterized by bleeding on the brain's surface) and 137 unspecified strokes occurred.
Dr Larsson and her colleagues found a 22-25 percent lower adjusted risk of total stroke, cerebral infarction, and subarachnoid hemorrhage among women who drank at least one cup of coffee per day compared with those who consumed less. Drinking more than one to two cups of coffee was not associated with significantly greater benefit. The dietary questionnaires completed by the participants did not differentiate between regular or decaffeinated coffee, however, the authors note that decaffeinated coffee consumption is uncommon in Sweden.
Reduction of subclinical inflammation and oxidative stress, and improved insulin sensitivity were suggested as possible mechanisms for coffee's benefits in lowering stroke risk.
"Our research group has previously observed an inverse association between coffee consumption and risk in Finnish male smokers," Dr Larsson stated. "We wanted to assess the situation in women."
"Some women have avoided consuming coffee because they have thought it is unhealthy," she added. "In fact, increasing evidence indicates that moderate coffee consumption may decrease the risk of some diseases such as diabetes, liver cancer and possibly stroke."
"To our knowledge, only one previous prospective study has assessed the association between coffee consumption and the incidence of stroke among healthy women," the authors write. "Given that coffee is one of the most popular beverages consumed worldwide, even small health effects of substances in coffee may have large public health consequences."
Stroke prevention is a subject of much debate. Approximately 25 percent of people who recover from a first stroke will have a second within five years. While the chance of death and disability increases with each stroke, risk of another stroke appears to be greatest within the first year (National Stroke Association 2005).
Using measurements such as the degree of artery occlusion (how much of the carotid artery is blocked by atherosclerotic plaques), medical experts have sought to establish firm guidelines to help physicians choose between the various options, including medication, angioplasty, and surgery. Common prescription drugs used to help prevent stroke include antihypertensive agents (Gorelick PB et al 1999; Goldstein LB et al 2001), cholesterol lowering agents (statins), and antiarrhythmics to help control irregular heartbeats that might contribute to stroke risk. Angioplasty is a procedure in which a balloon is threaded into the artery and inflated rapidly, crushing the plaque against the arterial wall and opening the artery. The most common surgery used to prevent stroke is called carotid endarterectomy, in which the surgeon opens the arteries in the neck and strips away the inner lining of the artery.
While these strategies have been shown to work in specific circumstances, a common flaw also unites them: they are often used only after stroke risk has reached an unacceptable level. Life Extension prefers a much more proactive approach. By using advanced early screening tests to determine risk, then taking action to improve endothelial function and reduce blood risk factors (such as homocysteine and fibrinogen) and blood pressure, Life Extension seeks to maintain the lowest possible risk profile.
Multiple studies have found that a diet high in fruits and vegetables lowers risk of cerebrovascular disease and both ischemic and hemorrhagic stroke (Gariballa SE 2000; Sauvaget C et al 2003). Two major reviews recommended that public health policy promote increased dietary intake of antioxidant vitamin C, beta-carotene, vitamin E, B vitamins (including folate), potassium, calcium, magnesium, vitamin D, fiber, and omega-3 fatty acids to reduce risk of stroke (Gariballa SE 2000; Johnsen SP 2004). These vital nutrients can also be obtained through dietary supplements in conjunction with a healthy diet.
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