TY - JOUR
T1 - Plasma copper and the risk of first stroke in hypertensive patients
T2 - a nested case-control study
AU - Zhang, Jingping
AU - Cao, Jingjing
AU - Zhang, Hao
AU - Jiang, Chongfei
AU - Lin, Tengfei
AU - Zhou, Ziyi
AU - Song, Yun
AU - Li, Youbao
AU - Liu, Chengzhang
AU - Liu, Lishun
AU - Wang, Binyan
AU - Tang, Genfu
AU - Li, Jianping
AU - Zhang, Yan
AU - Cui, Yimin
AU - Huo, Yong
AU - Yang, Yan
AU - Ling, Wenhua
AU - Yang, Jingang
AU - Guo, Huiyuan
AU - Wang, Xiaobin
AU - Xu, Xiping
AU - Qin, Xianhui
N1 - Funding Information:
Supported by National Key Research and Development Program grants 2016YFE0205400 (to XX), 2016YFC0903103 (to YH), 2016YFC0904900 (to YC), 2018ZX09739 (to XX), and 2018ZX09301034003 (to XX), Science and Technology Planning Project of Guangzhou, China grant 201707020010 (to XX), Science, Technology, and Innovation Committee of Shenzhen grants JSGG20170412155639040 and GJHS20170314114526143 (to XX), Economic, Trade, and Information Commission of Shenzhen Municipality grants 20170505161556110 and 20170505160926390 (to XX), National Natural Science Foundation of China grant 81730019 (to XQ), President Foundation of Nanfang Hospital, Southern Medical University grant 2017C007 (to YL), Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University grant 2017J009 (to XQ), and the Education Ministry of China’s 111th project grant B18053 (to HG).
Publisher Copyright:
© American Society for Nutrition 2019.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: Previous studies indicated that trace elements may play an important role in cardiovascular diseases. However, data concerning the association between blood copper and the risk of stroke are limited. Objective: The aim of this study was to evaluate the association between plasma copper and the risk of first stroke, and examine any possible effect modifiers in hypertensive patients. Methods: We conducted a nested case-control study, using data from the China Stroke Primary Prevention Trial. Hypertension is defined as systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg, or taking antihypertensive medication. A total of 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site were included in this study. The crude and adjusted risks of first stroke were estimated by ORs and 95% CIs using conditional logistic regression, without or with adjusting for pertinent covariates, respectively. Results: There were significant positive associations of plasma copper with risk of first stroke (per SD increment-OR: 1.20; 95% CI: 1.03, 1.39) and first ischemic stroke (OR: 1.26; 95% CI: 1.07, 1.50).When plasma copperwas categorized in quartiles, significantly higher risks of first stroke (OR: 1.72; 95% CI: 1.12, 2.65) and first ischemic stroke (OR: 1.91; 95% CI: 1.18, 3.11) were found in participants in quartile 4 (≥ 117.0 μg/dL) than in those in quartile 1 (< 91.2 μg/dL). Furthermore, the plasma copper-first stroke association was significantly stronger in participants with higher BMI (< 25.0 compared with ≥ 25.0 kg/m2, P-interaction = 0.024). However, there was no significant association between plasma copper and first hemorrhagic stroke. Conclusions: In Chinese hypertensive patients, there was a significant positive association between baseline plasma copper and the risk of first stroke, especially among those with higher BMI. This trial was registered at clinicaltrials.gov as NCT00794885.
AB - Background: Previous studies indicated that trace elements may play an important role in cardiovascular diseases. However, data concerning the association between blood copper and the risk of stroke are limited. Objective: The aim of this study was to evaluate the association between plasma copper and the risk of first stroke, and examine any possible effect modifiers in hypertensive patients. Methods: We conducted a nested case-control study, using data from the China Stroke Primary Prevention Trial. Hypertension is defined as systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg, or taking antihypertensive medication. A total of 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site were included in this study. The crude and adjusted risks of first stroke were estimated by ORs and 95% CIs using conditional logistic regression, without or with adjusting for pertinent covariates, respectively. Results: There were significant positive associations of plasma copper with risk of first stroke (per SD increment-OR: 1.20; 95% CI: 1.03, 1.39) and first ischemic stroke (OR: 1.26; 95% CI: 1.07, 1.50).When plasma copperwas categorized in quartiles, significantly higher risks of first stroke (OR: 1.72; 95% CI: 1.12, 2.65) and first ischemic stroke (OR: 1.91; 95% CI: 1.18, 3.11) were found in participants in quartile 4 (≥ 117.0 μg/dL) than in those in quartile 1 (< 91.2 μg/dL). Furthermore, the plasma copper-first stroke association was significantly stronger in participants with higher BMI (< 25.0 compared with ≥ 25.0 kg/m2, P-interaction = 0.024). However, there was no significant association between plasma copper and first hemorrhagic stroke. Conclusions: In Chinese hypertensive patients, there was a significant positive association between baseline plasma copper and the risk of first stroke, especially among those with higher BMI. This trial was registered at clinicaltrials.gov as NCT00794885.
KW - Body mass index
KW - Copper
KW - First ischemic stroke
KW - First stroke
KW - Hypertensive patients
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U2 - 10.1093/ajcn/nqz099
DO - 10.1093/ajcn/nqz099
M3 - Article
C2 - 31161196
AN - SCOPUS:85068601373
SN - 0002-9165
VL - 110
SP - 212
EP - 220
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 1
M1 - nzq099
ER -