Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke Basel Prospective Study

Abstract

Previous cross-cultural comparisons of the mortality from ischemic heart disease in European communities with associated plasma levels of essential antioxidants have revealed strong inverse correlations for vitamin E and relatively weak correlations for other antioxidants. Similarly, in a case-control study in Edinburgh low plasma levels of vitamin E were significantly associated with an increased risk of previously undiagnosed angina pectoris whereas low levels of other essential antioxidants lacked statistical significance. The current Basel Prospective Study is particularly well suited to elucidate the impact of antioxidants other than vitamin E. In this population (which was recently evaluated regarding cancer mortality) the plasma levels of vitamins E and A are exceptionally high and above the presumed threshold level of risk for ischemic heart disease. The present 12-year follow-up of cardiovascular mortality in this study reveals a significantly increased relative risk of ischemic heart disease and stroke at initially low plasma levels of carotene (< 0.23 mumol/l) and/or vitamin C (< 22.7 mumol/l), independently of vitamin E and of the classical cardiovascular risk factors. Low levels of both carotene and vitamin C increase the risk further, in the case of stroke even with significance for overmultiplicative interaction. In conclusion, in cardiovascular disease independent inverse correlations may exist for every major essential antioxidant although the latter can also interact synergistically. Therefore future intervention trials of antioxidants in the prevention of ischemic heart disease should primarily test the simultaneous optimization of the status of all principal essential antioxidants.

Low plasma retinol predicts coronary events in healthy middle-aged men: The PRIME Study

“…This contrasts with results in healthy middle-aged US smokers [14], and in Swiss with a 42% smoking prevalence [15]. Since smoking was strongly predictive in PRIME and was associated with low carotenoid levels, these results [14,15] may have been due to confounding by lifestyle factors, e.g. fruit/vegetable intake.…”

Nutrition, ageing and ill health

“…There have been three major epidemiological complementary studies of the association between low plasma concentration of diet-derived antioxidants and the risk of IHD and stroke: the WHO MONICA Project (1989); the Edinburgh Angina-Control Study (Riemersma et al 1991); the Basel Prospective Study (Gey et al 1993). These studies consistently revealed an association between increased risk of IHD (and stroke) and low plasma concentrations of antioxidants.…”

Quercetin intake and the incidence of cerebrovascular disease

“…Antioxidants prevent the oxidation of low-density lipoproteins and may therefore reduce the occurrence of ischaemic heart disease and cerebrovascular disease (CVA) (Steinberg et al, 1989;Gey et al, 1993). Since¯avonoids are effective antioxidants, it is plausible that they provide protection against CVA (Shutenko et al, 1999).…”