Carotenoids as potential antioxidant agents in stroke prevention: A systematic review

Stroke and other cerebrovascular diseases are among the most common causes of death worldwide. Prevention of modifable risk factors is a cost‑effective approach to decrease the risk of stroke. Oxidative stress is regarded as the major flexible operative agent in ischemic brain damage. This review presents recent scientifc advances in understanding the role of carotenoids as antioxidants in lowering stroke risk based on observational studies. We searched Medline using the following terms: (Carotenoids [MeSH] or Carotenes [tiab] or Carotene [tiab] or “lycopene [Supplementary Concept]” [MeSH] or lycopene [tiab] or beta‑Carotene [tiab]) and (stroke [MeSH] or stroke [tiab] or “Cerebrovascular Accident” [tiab] or “Cerebrovascular Apoplexy” [tiab] or “Brain Vascular Accident” [tiab] or “Cerebrovascular Stroke” [tiab]) and (“oxidative stress” [MeSH] or “oxidative stress”[tiab]). This search considered papers that had been published between 2000 and 2017. Recent studies indicated that high dietary intake of six main carotenoids (i.e., lycopene, ⟨‑ and ‑carotene, lutein, zeaxanthin, and astaxanthin) was associated with reduced risk of stroke and other cardiovascular outcomes. However, the main mechanism of the action of these nutrients was not identifed, and multiple mechanisms except antioxidant activity were suggested to be involved in the observed benefcial effects. The dietary intake of six major carotenoids should be promoted as this may have a substantial positive effect on stroke prevention and stroke mortality reduction.