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Antioxidant vitamin status and carotid atherosclerosis in the elderly^1,2,3

¹ From the MRC Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital, Southampton, United Kingdom; the Directorate of Medical Physics and Clinical Technology, Northern General Hospital, Sheffield, United Kingdom; and the Centre for Human Nutrition (University of Sheffield), Northern General Hospital, Sheffield, United Kingdom.

Background: The oxidative modification of LDL is thought to play a crucial role in the initiation of atherosclerosis. Antioxidant vitamins can protect LDL from oxidation, and high intakes or blood concentrations of these vitamins have been linked with a reduced risk of cardiovascular disease. Few data are available on the importance of antioxidant vitamins in earlier stages of atherogenesis.

Objective: We investigated the cross-sectional relation between antioxidant vitamin status and carotid atherosclerosis in a group of elderly persons.

Design: The study sample comprised 468 men and women aged 66–75 y living in Sheffield, United Kingdom. Duplex ultrasonography was used to measure intima-media thickness and the degree of stenosis in the extracranial carotid arteries. Antioxidant vitamin status was assessed by measuring fasting plasma concentrations of vitamin C, vitamin E, and ß-carotene.

Results: In the men, after adjustment for age and cardiovascular disease risk factors, a 20% higher plasma vitamin C concentration was associated with a 0.004-mm smaller intima-media thickness; a 20% higher ß-carotene concentration was associated with a 0.005-mm smaller intima-media thickness. Compared with men with high blood concentrations of ß-carotene or cholesterol-adjusted vitamin E, those with low blood concentrations of these vitamins were 2.5 times as likely to have carotid stenosis of >30%. We found no significant trends between plasma concentrations of antioxidant vitamins and either measure of carotid atherosclerosis in the women.

Conclusion: A high antioxidant vitamin status may help to prevent the initiation and progression of early atherosclerotic lesions in men.

Key Words: Carotid artery disease • atherosclerosis • dietary antioxidants • vitamin C • vitamin E • ß-carotene • elderly • low-density lipoprotein • LDL • oxidation

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