Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

W. Sumner Davis

Abstract

Individuals with poor nutritional vitamin K status can suffer from atrial fibrillation (AF) due to misinterpretation of warfarin instructions by healthcare providers. The purpose of this quantitative study was to determine if there was an association between inadequate dietary vitamin K intake in AF patients and stroke outcomes to address the lack of research surrounding stroke outcomes in patients with true vitamin K deficiency. Grounded in the health belief model, this study assessed if individual beliefs from health education influenced the nutritional quality of their diet and health outcomes. The study is a secondary data analysis of the Framingham Heart Study. Longitudinal data from the Offspring cohort collected from 1971 to 2014 were included. All AF patients with no prior history of stroke were eligible, resulting in a sample size of 471. The association between dietary vitamin K, serum vitamin K levels, and stroke outcomes was analyzed using bivariate regression analyses and multivariate regression analysis. There was an increased risk for ischemic stroke was seen with lower dietary intake levels (OR 1.18 – 1.46) and lower serum vitamin k levels (OR 1.32 – 1.47) while controlling for age, gender, education level, income level, smoking status, alcohol abuse, diabetes mellitus, high blood pressure, high cholesterol, and obesity; however, results are not statistically significance (p > .05). The findings can promote positive social change by informing care protocols and policies on safe levels of vitamin K foods to consume and health improvement programs for routine vitamin K monitoring in the population, resulting in a reduction in population mortality rates for heart attack and stroke.

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