Skip to main content
SpringerLink
Log in

Beta-carotene intake and risk of nonfatal acute myocardial infarction in women

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

There are indications that beta-carotene, but not pre-formed vitamin A, is protective on the risk of acute myocardial infarction (AMI). The relationship between nonfatal AMI and the intake of beta-carotene and retinol was investigated in a case-control study conducted between 1983 and 1992 in northern Italy on 433 women with nonfatal AMI and 869 controls in hospital for acute, non-cardiovascular, non-neoplastic, non-digestive, non-hormone related conditions. Odds ratios (OR), with their 95% confidence intervals (CI), were computed by unconditional multiple logistic regression analysis, including terms for age, education, body mass index, smoking, alcohol and coffee drinking, menopausal status, hormone replacement therapy and history of diabetes, hypertension and hyperlipidemia. The risk of AMI was inversely related to beta-carotene intake, with an OR of 0.5 (95% CI: 0.3 to 0.8) for the highest quintile of intake compared to the lowest (χ2 trend = 10.53, p < 0.01). Retinol intake was not associated with AMI, with an OR of 0.9 (95% CI: 0.6 to 1.3) for the highest quintile of intake compared to the lowest. Analysis in separate strata of covariates indicated that the inverse association of beta-carotene intake with risk of AMI was appreciably stronger in younger, lean women with no history of diabetes or hypertension, and in current smokers. The results of this study indicate that the risk of nonfatal AMI in women is inversely related to intake of beta-carotene containing foods, but not foods containing retinol.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gey KF, Puska P. Plasma vitamins E and A inversely correlated to mortality from ischemic heart disease in cross-cultural epidemiology. Ann NY Acad Sci 1989; 570: 268–282.

    Google Scholar 

  2. Gaziano JM, Manson JE, Buring JE, Hennekens CH. Dietary antioxidants and cardiovascular disease. Ann NY Acad Sci 1992; 669: 249–259.

    Google Scholar 

  3. Gey KF, Moser UK, Jordan P, Stahelin HB, Eichholzer M, Ludin E. Increased risk of cardiovascular disease at suboptimal plasma concentrations of essential antioxidants: An epidemiological update with special attention to carotene and vitamin C. Am J Clin Nutr 1993; 57(suppl): 787S–797S.

    Google Scholar 

  4. Gey KF. Prospects for the prevention of free radical disease, regarding cancer and cardiovascular disease. Br Med Bull 1993; 49: 679–699.

    Google Scholar 

  5. Gaziano JM, Hennekens CH. The role of beta-carotene in the prevention of cardiovascular disease. Ann NY Acad Sci 1993; 691: 148–155.

    Google Scholar 

  6. Gaziano JM. Antioxidant vitamins and coronary artery disease risk. Am J Med 1994; 97(suppl 3A): 18S–21S.

    Google Scholar 

  7. Oliver MF. Antioxidant nutrients, atherosclerosis, and coronary heart disease. Br Heart J 1995; 73: 299–301.

    Google Scholar 

  8. Manson JE, Stampfer MJ, Willett WC, et al. A prospective study of antioxidant vitamins and incidence of coronary heart disease in women. Circulation 1991; 84(suppl 11): 11–546.

    Google Scholar 

  9. Gaziano JM, Manson JE, Branch LG, Colditz GA, Willett WC, Buring JE. A prospective study of consumption of carotenoids in fruits and vegetables and decreased cardiovascular mortality in the elderly. Ann Epidemiol 1995; 5: 255–260.

    Google Scholar 

  10. Rimm EB, Stampfer MJ, Ascherio A, Giovanucci E, Colditz GA, Willett WC. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 1993; 328: 1450–1456.

    Google Scholar 

  11. Knekt P, Reunanen A, Jarvinen R, Seppanen R, Heliovaara M, Aromaa A. Am J Epidemiol 1994; 139: 1180–1189.

    Google Scholar 

  12. Gey KF, Stahelin HB, Eichholzer M. Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke: Basel prospective study. Clin Invest 1993; 71: 3–6.

    Google Scholar 

  13. Morris DL, Kritchevsky SB, Davis CE. Serum carotenoids and coronary heart disease: The lipid research clinics coronary primary prevention trial and follow-up study. JAMA 1994; 272: 1439–1441.

    Google Scholar 

  14. Gey KF, Puska P, Jordan P, Moser UK. Inverse correlation between plasma vitamin E and mortality from ischemic heart disease in cross-cultural epidemiology. Am J Clin Nutr 1991; 53: 326S–334S.

    Google Scholar 

  15. Riemersma RA, Wood DA, Macintyre CCA, Elton RA, Gey KF, Oliver MF. Risk of angina pectoris and plasma concentrations of vitamins A, C, and E and carotene. Lancet 1991; 337: 1–5.

    Google Scholar 

  16. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330: 1029–1035.

    Google Scholar 

  17. Hennekens CH, Buring JE, Manson JE, Stampfer M, Rosner B, Cook NR, Belanger C, LaMotte F, Gaziano JM, Ridker PM, Willett W, Peto R. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996; 334: 1145–1149.

    Google Scholar 

  18. Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FL Jr, Valanis B, Williams JH Jr, Barnhart S, Hammar S. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 1996; 334: 1150–1155.

    Google Scholar 

  19. Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM. Dietary antioxidant vitamins and death from coronary heart disease in pstmenopausal women. N Engl J Med 1996; 334: 1156–1162.

    Google Scholar 

  20. Greenberg ER, Sporn MB. Antioxidant vitamins, cancer, and cardiovascular disease. N Engl J Med 1996; 334: 1189–1190.

    Google Scholar 

  21. Salonen JT, Salonen R, Penttila I, et al. Serum fatty acids, apolipoproteins, selenium and vitamin antioxidants and the risk of death from coronary artery disease. Am J Cardiol 1985; 56: 226–231.

    Google Scholar 

  22. Kok FJ, de Bruijn AM, Vermeeren R, et al. Serum selenium, vitamin antioxidants, and cardiovascular mortality: A 9-year follow-up study in the Netherlands. Am J Clin Nutr 1987; 45: 462–468.

    Google Scholar 

  23. Street DA, Comstock GW, Salkeld RM, Schuep W, Klag M. A population-based case-control study of the association of serum antioxidants and myocardial infarction. Am J Epidemiol 1991; 134: 719–720.

    Google Scholar 

  24. Street DA, Comstock GW, Salkeld RM, Schuep W, Klag MJ. Serum antooxidants and myocardial infarction: Are low levels of carotenoids and a-tocopherol risk factors for myocardial infarction? Circulation 1994; 90: 1154–1161.

    Google Scholar 

  25. Kardinaal AFM, Kok FJ, Ringstad J, et al. Antioxidants in adipose tissue and risk of myocardial infarction: The EURAMIC study. Lancet 1993; 342: 1379–1384.

    Google Scholar 

  26. Buring JE, Hennekens CH. Randomized trials of primary prevention of cardiovascular disease in women: An investigator's view. Ann Epidemiol 1994; 4: 111–114.

    Google Scholar 

  27. La Vecchia C, Franceschi S, Decarli A, Pampollona S, Tognoni G. Risk factors for myocardial infarction in young women. Am J Epidemiol 1987; 125: 832–843.

    Google Scholar 

  28. Ischemic Heart Disease Registers. Report of the Fifth Working Group. Copenhagen: World Health Organization, 1971.

    Google Scholar 

  29. Carnovale E, Miuccio F. Tabelle di Composizione degli Alimenti. Rome: Istituto Nazionale della Nutrizione, 1989.

  30. Breslow NE, Day NE. Statistical methods in cancer research, Vol. 1: The analysis of case-control studies. Lyon: IARC Sci Publ, 1980: 32.

    Google Scholar 

  31. Todd S, Woodward M, Bolton-Smith C. An investigation of the relationship between antioxidant vitamin intake and coronary heart disease in men and women using logistic regression analysis. J Clin Epidemiol 1995; 48: 307–316.

    Google Scholar 

  32. La Vecchia C, Negri E, Franceschi S, Parazzini F, Decarli A. Differences in dietary intake with smoking, alcohol, and education. Nutr Cancer 1992; 17: 297–304.

    Google Scholar 

  33. Steinberg D, Antioxidants and atherosclerosis: A current assessment. Circulation 1991; 84: 1420–1425.

    Google Scholar 

  34. Halliwell B. Free radicals and vascular disease: How much do we know? Br Med J 1993; 307: 885.

    Google Scholar 

  35. Singh RB, Niaz MA, Rastogi S, Sharma JP, Kumar R, Bishnoi I, Beegom R. Plasma level of antioxidant vitamins and oxidative stress in patients with suspected acute myocardial infarction. Acta Cardiol 1994; 49: 441–452.

    Google Scholar 

  36. Singh RB, Niaz MA, Ahmad S, Begum R, Agarwal P. Effect of antioxidant rich foods on plasma ascorbic acid, cardiac enzyme and lipid peroxides levels in patients hospitalized with acute myocardial infarction. J Am Diet Assoc 1995; 95: 775–780.

    Google Scholar 

  37. Singh RB, Niaz MA, Rastogi SS, Rastogi S. Usefulness of antioxidant vitamins in suspected acute myocardial infarction (The Indian experiment of infarct survival-3). Am J Cardiol 1996; 77: 232–236.

    Google Scholar 

  38. Allard JP, Royall D, Kurian R, Muggli R, Jeejeebhoy KN. Effects of β-carotene supplementation on lipid peroxidation in humans. Am J Clin Nutr 1994; 59: 884–890.

    Google Scholar 

  39. Princen HMG, van Poppel G, Vogelezang C, Buytenhek R, Kok FJ. Supplementation with vitamin E but not b-carotene in vivo protects low density lipoprotein from lipid peroxidation in vitro: Effect of cigarette smoking. Arterioscler Thromb 1992; 12: 554–562.

    Google Scholar 

  40. Ringer TV, DeLoof MJ, Winterrowd GE, et al. Betacarotene's effects on serum lipoproteins and immunologic indices in humans. Am J Clin Nutr 1991; 53: 688–694.

    Google Scholar 

  41. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 1959; 22: 719–748.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milano, Italy

    Alessandra Tavani, Eva Negri, Barbara D'Avanzo & Carlo La Vecchia

  2. Istituto di Statistica Medica e Biometria, Università di Milano, Milano, Italy

    Carlo La Vecchia

Authors
  1. Alessandra Tavani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eva Negri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara D'Avanzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlo La Vecchia
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tavani, A., Negri, E., D'Avanzo, B. et al. Beta-carotene intake and risk of nonfatal acute myocardial infarction in women. Eur J Epidemiol 13, 631–637 (1997). https://doi.org/10.1023/A:1007376901183

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007376901183

Search

Navigation