201. Six-Year Effect of Combined Vitamin C and E Supplementation on Atherosclerotic Progression
- Author
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Tomi-Pekka Tuomainen, Ulla Ristonmaa, Riitta Salonen, Veli-Pekka Valkonen, Kristiina Nyyssönen, Jukka T. Salonen, Meri Vanharanta, Hanna-Maaria Lakka, Sari Voutilainen, Jari Kaikkonen, Tiina H. Rissanen, Henrik E. Poulsen, and Elina Porkkala-Sarataho
- Subjects
Carotid Artery Diseases ,Male ,medicine.medical_specialty ,Time Factors ,Arteriosclerosis ,Carotid Artery, Common ,medicine.medical_treatment ,Hypercholesterolemia ,Ascorbic Acid ,Gastroenterology ,Antioxidants ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Physiology (medical) ,Internal medicine ,medicine.artery ,Humans ,Vitamin E ,Medicine ,Common carotid artery ,Aged ,Ultrasonography ,F2-Isoprostanes ,Vitamin C ,business.industry ,Cholesterol ,Cholesterol, HDL ,Middle Aged ,medicine.disease ,Ascorbic acid ,Clinical trial ,Endocrinology ,chemistry ,Delayed-Action Preparations ,Dietary Supplements ,Disease Progression ,Patient Compliance ,Drug Therapy, Combination ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background— Self-selected supplementation of vitamin E has been associated with reduced coronary events and atherosclerotic progression, but the evidence from clinical trials is controversial. In the first 3 years of the ASAP trial, the supplementation with 136 IU of vitamin E plus 250 mg of slow-release vitamin C twice daily slowed down the progression of carotid atherosclerosis in men but not women. This article examines the 6-year effect of supplementation on common carotid artery (CCA) intima-media thickness (IMT). Methods and Results— The subjects were 520 smoking and nonsmoking men and postmenopausal women aged 45 to 69 years with serum cholesterol ≥5.0 mmol/L (193 mg/dL), 440 (84.6%) of whom completed the study. Atherosclerotic progression was assessed ultrasonographically. In covariance analysis in both sexes, supplementation reduced the main study outcome, the slope of mean CCA-IMT, by 26% (95% CI, 5 to 46, P =0.014), in men by 33% (95% CI, 4 to 62, P =0.024) and in women by 14% (not significant). In both sexes combined, the average annual increase of the mean CCA-IMT was 0.014 mm in the unsupplemented and 0.010 mm in the supplemented group (25% treatment effect, 95% CI, 2 to 49, P =0.034). In men, this treatment effect was 37% (95 CI, 4 to 69, P =0.028). The effect was larger in subjects with either low baseline plasma vitamin C levels or CCA plaques. Vitamin E had no effect on HDL cholesterol. Conclusions— These data replicate our 3-year findings confirming that the supplementation with combination of vitamin E and slow-release vitamin C slows down atherosclerotic progression in hypercholesterolemic persons.
- Published
- 2003