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Antioxidant Vitamins and Cardiovascular Disease

  • Chapter
Preventive Nutrition

Part of the book series: Nutrition ◊ and ◊ Health ((NH))

Abstract

The hypothesis that antioxidant vitamins may reduce risks of cardiovascular disease has been the subject of considerable research attention in recent years. Basic research studies have provided evidence of possible mechanisms for an effect of antioxidants on atherosclerosis, and several observational epidemiologic studies have suggested that risk of coronary heart disease (CHD) may be 20–40% lower among those with high dietary intake or serum levels of antioxidant vitamins. CHD remains the leading cause of death in the United States, as well as most developed countries, accounting for approximately one of every four deaths. For this reason, even the modest reductions in CHD risk suggested by studies to date, if real, could yield substantial public health benefits. At present, however, available data remain inadequate to draw firm conclusions regarding the possible role of antioxidant vitamins in the prevention of cardiovascular disease. This chapter reviews the evidence on antioxidants and cardiovascular disease, discusses its strengths and limitations, and summarizes the trials now ongoing.

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References

  1. Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL. Beyond cholesterol: modifications of lowdensity lipoprotein that increase its atherogenicity. New Engl J Med 1989; 320:915–924.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  3. Smith TL, Kummerow FA. Effect of dietary vitamin E on plasma lipids and atherogenesis in restricted anovulatory chickens. Atherosclerosis 1989; 75:105–109.

    CAS  Google Scholar 

  4. Wojcicki J, Rozewicka L, Barcew-Wiszniewska B, Samochowiec L, Juzwiak S, Kadlubowska D, Tustanowski S, Juzyszyn Z. Effect of selenium and vitamin E on the development of experimental atherosclerosis in rabbits. Atherosclerosis 1991; 87:9–19.

    CAS  Google Scholar 

  5. Verlangieri AJ, Bush M. Prevention and regression of atherosclerosis by alpha-tocopherol. J Am Coll Nutr 1992; 11:131–138.

    CAS  Google Scholar 

  6. Willis GC. An experimental study of the intimal ground substance in atherosclerosis. Can Med Assoc J 1953; 69:17–22.

    CAS  Google Scholar 

  7. Willis GC. The reversibility of atherosclerosis. Can MedAssoc J 1957; 77:106–109.

    CAS  Google Scholar 

  8. Carew T, Schwenke D, Steinberg D. Antiatherogenic effect of probucol unrelated to its hypercholesterolemic effect: evidence that antioxidants in vivo can selectively inhibit low density lipoprotein degradation in macrophage-rich fatty streaks and slow the progression of atherosclerosis in the watanabe heritable hypercholesterolemic rabbits. Proc Natl Acad Sci USA 1987;84:7725–7729.

    Article  CAS  Google Scholar 

  9. Acheson RM, Williams DRR. Does consumption of fruit and vegetables protect against stroke? Lancet 1983; 1:1191–1193.

    Article  CAS  Google Scholar 

  10. Armstrong BK, Mann JL, Adelstein AM, Eskin F. Commodity consumption and ischemic heart disease mortalitv, with special reference to dietary practices. J Chronic Dis 1975; 36:673–677.

    Google Scholar 

  11. Gey KF, Brubacher GB, Stahelin HB. Plasma levels of antioxidant vitamins in relation to ischemic heart disease and cancer. Am J Clin Nutr 1987: 45:1368–1377.

    CAS  Google Scholar 

  12. 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.

    CAS  Google Scholar 

  13. Salonen JT, Solonen R, Seppanen K, Kantola M, Parviainen M, Alfthan G, Maenpaa PH, Taskinen E, Rauramaa R. Relationship of serum selenium and antioxidants to plasma lipoproteins, platelet aggregability and prevalent ischemic heart disease in eastern Finnish men. Atherosclerosis 1988; 70:155–160.

    Article  CAS  Google Scholar 

  14. Riemersma RA, Oliver M, Elton RA, Alfthan G, Vartiainen E, Salo M, Rubba P, Mancici M, Georgi H, Vuilleumier J-P, Gey KF. Plasma antioxidants and coronary heart disease: vitamins C and E, and selenium. Eur J Clin Nutr 1990; 44:143–150.

    CAS  Google Scholar 

  15. Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the risk of coronary disease in women. New Engl J Med 1993; 328:1444–1449.

    Article  CAS  Google Scholar 

  16. Manson JE, Stampfer MJ, Willett WC, Colditz GA, Rosner B, Speizer FE, Hennekens CH. A prospective study of vitamin C and incidence of coronary heart disease in women. Circulation 1992; 85:865 (abstract).

    Google Scholar 

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

    Google Scholar 

  18. Gaziano JM, Branch LG, Manson JE, Colditz GA, Willett WC, Buring JE, Hennekens CH. A prospective study of beta-carotene in fruits and vegetables and decreased cardiovascular mortality in the elderly. Ann Epidemiol 1995; 5:255–260.

    Article  CAS  Google Scholar 

  19. Enstrom JE, Kanim LE, Klein MA. Vitamin C intake and mortality among a sample of the United States population. Epidemiol 1992; 3:194–202.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  21. Salonen JT, Salonen R, Penttila I, Herranen J, Jauhiainen M, Kantola M, Lappetelainen R, Maenpaa P, Alfthan G, Puska P. Serum fatty acids, apolipoproteins, selenium and vitamin antioxidants and risk of death from coronary artery disease. Am J Cardiol 1985; 56:226–231.

    Article  CAS  Google Scholar 

  22. Kok FJ, de Bruijn AM, Vermeeren R, Hofman A, VanLaar A, deBruin M, Hermus RJT, Valkenberg HA. Serum selenium, vitamin antioxidants and cardiovascular mortality: a 9 year follow-up study in the Netherlands. Am J Clin Nutr 1987; 45:462–468.

    CAS  Google Scholar 

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

    Google Scholar 

  24. Hennekens CH, Buring JE. Epidemiology in Medicine. Boston: Little, Brown and Company, 1987.

    Google Scholar 

  25. Steinberg D and workshop participants. Antioxidants in the prevention of human atherosclerosis: summary proceedings of a National Heart, Lung, and Blood Institute Workshop: September 5–6, 1991; Bethesda, MD. Circulation 1992; 85:2337–2347.

    Google Scholar 

  26. Blot WJ, Li J-Y, Taylor PR, Guo W, Dawsey S, Wang GQ, Yang CS, Zheng SF, Gail M, Li GY, Yu Y, Liu BQ, Tangrea J, Sun YH, Liu F, Fraumeni JF, Zhang YH, Li B. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993; 85:1483–1492.

    Article  CAS  Google Scholar 

  27. 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. New Engl J Med 1994; 330:1029–1035.

    Google Scholar 

  28. Hennekens CH, Buring JE, Peto R. Antioxidant vitamins-benefits not yet proved. New Engl J Med 1994; 330:1080,1081.

    Google Scholar 

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

    Article  CAS  Google Scholar 

  30. Steering Committee of the Physicians’ Health Study Research Group. Final report on the aspirin component of the ongoing Physicians’ Health Study. New Engl J Med 1989; 321:129–135.

    Article  Google Scholar 

  31. Hennekens CH, Buring JE, Manson, JE, Stampfer MJ, 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. New Engl J Med 1996; 334: 1145–1149.

    Article  CAS  Google Scholar 

  32. Gaziano JM, Manson JE, Ridker PM, Buring JE, Hennekens CH. Beta carotene therapy for chronic stable angina (abstract). Circulation 1990; 82(4, Suppl III):III-202.

    Google Scholar 

  33. Livingston PD, Jones C. Treatment of intennittent claudication with vitamin E. Lancet 1958; 2:602–604.

    Article  Google Scholar 

  34. Williams HTG, Fenna D, MacBeth RA. Alpha-tocopherol in the treatment of intermittent claudication. Surg Gynecol Obstet 1971; 132:662–666.

    CAS  Google Scholar 

  35. Haeger K. Long-time treatment of intermittent claudication with vitamin E. Am J Clin Nutr 1974; 427:1179–1181.

    Google Scholar 

  36. Gillilan RE, Mandell B, Warbassee JR. Quantitative evaluation of vitamin E in the treatment of angina pectoris. Am Heart J 1988; 93:444–449.

    Article  Google Scholar 

  37. Stephens NG, Parsons A, Schofield PM, Kelly F, Cheeseman K, Mitchinson MJ, Brown MJ. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996; 347:781–786.

    CAS  Google Scholar 

  38. Buring JE, Hennekens CH, for the Women’s Health Study Research Group. The Women’s Health Study: summary of the study design. J Myocardial Ischemia 1992; 4:27–29.

    Google Scholar 

  39. Manson JE, Gaziano JM, Spelsberg A, Ridker PM, Buring JE, Willett WC, Hennekens CH. A secondary prevention trial of antioxidant vitamins and cardiovascular disease in women: rationale, design and methods. Ann Epidemiol 1985; 5:261–265.

    Article  Google Scholar 

  40. The HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluation) Study. The design of a large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. Can J Cardiol 1996; 12:127–137.

    Google Scholar 

  41. Jha P, Flather M, Lonn E, Farkouh M, Yusuf S. The antioxidant vitamins and cardiovascular disease. A critical review of epidemiologic and clinical trial data. Ann Intem Med 1995; 123:860–872.

    CAS  Google Scholar 

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Authors
  1. Julie E. Buring
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  2. J. Michael Gaziano
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Editor information

Editors and Affiliations

  1. SmithKline Beecham Consumer Health Care, Parsippany, NJ, USA

    Adrianne Bendich PhD

  2. Columbia University, New York, NY, USA

    Richard J. Deckelbaum MD

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© 1997 Springer Science+Business Media New York

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Buring, J.E., Gaziano, J.M. (1997). Antioxidant Vitamins and Cardiovascular Disease. In: Bendich, A., Deckelbaum, R.J. (eds) Preventive Nutrition. Nutrition ◊ and ◊ Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4757-6242-6_9

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  • DOI: https://doi.org/10.1007/978-1-4757-6242-6_9

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-6244-0

  • Online ISBN: 978-1-4757-6242-6

  • eBook Packages: Springer Book Archive

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