Table 1: Micronutrients and mechanisms through which their deficiencies induce cerebrovascular alterations and increase the risk of stroke.

MicronutrientMechanism

Folic acid
Cofactor in homocysteine metabolismHyperhomocysteinemia (potentially atherogenic)

B vitamins
(i) B6 and B12: cofactors in homocysteine metabolism(i) Hyperhomocysteinemia (potentially atherogenic)
(ii) Potentially antioxidants(ii) Oxidative stress

Vitamin D
(i) Controls parathormone levels(i) Secondary hyperparathyroidism:
(ii) Suppresses cholesterol uptake by the macrophages and foam cell formation – Insulin resistance and pancreatic b-cell dysfunction type 2 diabetes mellitus
 – Activation of the rennin-angiotensin-aldosterone system hypertension
(iii) Increases the size of high-density lipoprotein particles – Stimulation of systemic and vascular inflammation atherogenesis
(ii) Atherogenesis

Vitamins A, C, and E
AntioxidantsOxidative stress

Zinc
(i) Activates brain protein synthesis(i) Neurocognitive impairment
(ii) Controls newly formed synapses(ii) Impaired neurotransmission
(iii) Cofactor of superoxide dismutase(iii) Oxidative stress