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. 2016 Jan;11(1):93-102.
doi: 10.1177/1747493015607515.

Vitamin D deficiency and incident stroke risk in community-living black and white adults

Suzanne E Judd  1 , Charity J Morgan  1 , Bhupesh Panwar  2 , Virginia J Howard  3 , Virginia G Wadley  4 , Nancy S Jenny  5 , Brett M Kissela  6 , Orlando M Gutiérrez  7
Affiliations

Vitamin D deficiency and incident stroke risk in community-living black and white adults

Suzanne E Judd et al. Int J Stroke. 2016 Jan.

Abstract

Background: Black individuals are at greater risk of stroke and vitamin D deficiency than white individuals. Epidemiologic studies have shown that low 25-hydroxyvitamin D concentrations are associated with increased risk of stroke, but these studies had limited representation of black individuals.

Methods: We examined the association of 25-hydroxyvitamin D with incident stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white adults ≥45 years of age. Using a case-cohort study design, plasma 25-hydroxyvitamin D was measured in 610 participants who developed incident stroke (cases) and in 937 stroke-free individuals from a stratified cohort random sample of REGARDS participants (comparison cohort).

Results: In multivariable models adjusted for socio-demographic factors, co-morbidities and laboratory values including parathyroid hormone, lower 25-hydroxyvitamin D concentrations were associated with higher risk of stroke (25-hydroxyvitamin D >30 ng/mL reference; 25-hydroxyvitamin D concentrations 20-30 ng/mL, hazard ratio 1.33, 95% confidence interval (95% CI) 0.89,1.96; 25-hydroxyvitamin D <20 ng/mL, hazard ratio 1.85, 95% CI 1.17, 2.93). There were no statistically significant differences in the association of lower 25-hydroxyvitamin D with higher risk of stroke in black vs. white participants in fully adjusted models (hazard ratio comparing lowest vs. highest 25-hydroxyvitamin D category 2.62, 95% CI 1.18, 5.83 in blacks vs. 1.64, 95% CI 0.83, 3.24 in whites, P(interaction) = 0.82). The associations were qualitatively unchanged when restricted to ischemic or hemorrhagic stroke subtypes or when using race-specific cut-offs for 25-hydroxyvitamin D categories.

Conclusions: Vitamin D deficiency is a risk factor for incident stroke and the strength of this association does not appear to differ by race.

Keywords: Stroke; epidemiology; vitamin D.

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Conflict of interest statement

CONFLICTS OF INTEREST: No authors report any financial disclosures

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