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Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts.
Am J Clin Nutr. 2004 Dec; 80(6):1508-20.AJ

Abstract

BACKGROUND

Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear.

OBJECTIVE

We studied the relation between the intake of antioxidant vitamins and CHD risk.

DESIGN

A cohort study pooling 9 prospective studies that included information on intakes of vitamin E, carotenoids, and vitamin C and that met specific criteria was carried out. During a 10-y follow-up, 4647 major incident CHD events occurred in 293 172 subjects who were free of CHD at baseline.

RESULTS

Dietary intake of antioxidant vitamins was only weakly related to a reduced CHD risk after adjustment for potential nondietary and dietary confounding factors. Compared with subjects in the lowest dietary intake quintiles for vitamins E and C, those in the highest intake quintiles had relative risks of CHD incidence of 0.84 (95% CI: 0.71, 1.00; P=0.17) and 1.23 (1.04, 1.45; P=0.07), respectively, and the relative risks for subjects in the highest intake quintiles for the various carotenoids varied from 0.90 to 0.99. Subjects with higher supplemental vitamin C intake had a lower CHD incidence. Compared with subjects who did not take supplemental vitamin C, those who took >700 mg supplemental vitamin C/d had a relative risk of CHD incidence of 0.75 (0.60, 0.93; P for trend <0.001). Supplemental vitamin E intake was not significantly related to reduced CHD risk.

CONCLUSIONS

The results suggest a reduced incidence of major CHD events at high supplemental vitamin C intakes. The risk reductions at high vitamin E or carotenoid intakes appear small.

Authors+Show Affiliations

Knekt P
National Public Health Institute, Helsinki, Finland. paul.knekt@ktl.fi
Ritz J
No affiliation info available
Pereira MA
No affiliation info available
O'Reilly EJ
No affiliation info available
Augustsson K
No affiliation info available
Fraser GE
No affiliation info available
Goldbourt U
No affiliation info available
Heitmann BL
No affiliation info available
Hallmans G
No affiliation info available
Liu S
No affiliation info available
Pietinen P
No affiliation info available
Spiegelman D
No affiliation info available
Stevens J
No affiliation info available
Virtamo J
No affiliation info available
Willett WC
No affiliation info available
Rimm EB
No affiliation info available
Ascherio A
No affiliation info available

MeSH

AdultAgedAged, 80 and overAntioxidantsAscorbic AcidCarotenoidsCohort StudiesCoronary DiseaseDiet SurveysDietary SupplementsFemaleFollow-Up StudiesFruitHumansIncidenceMaleMiddle AgedProportional Hazards ModelsProspective StudiesRiskRisk FactorsVegetablesVitamin E

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15585762

Clinical Trial Links

Pooling of Cohort Studies on Diet & Coronary Disease
Efficacy of Vitamin C Injection on Fatigue in Workers After Work

Citation

Knekt, Paul, et al. "Antioxidant Vitamins and Coronary Heart Disease Risk: a Pooled Analysis of 9 Cohorts." The American Journal of Clinical Nutrition, vol. 80, no. 6, 2004, pp. 1508-20.
Knekt P, Ritz J, Pereira MA, et al. Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts. Am J Clin Nutr. 2004;80(6):1508-20.
Knekt, P., Ritz, J., Pereira, M. A., O'Reilly, E. J., Augustsson, K., Fraser, G. E., Goldbourt, U., Heitmann, B. L., Hallmans, G., Liu, S., Pietinen, P., Spiegelman, D., Stevens, J., Virtamo, J., Willett, W. C., Rimm, E. B., & Ascherio, A. (2004). Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts. The American Journal of Clinical Nutrition, 80(6), 1508-20.
Knekt P, et al. Antioxidant Vitamins and Coronary Heart Disease Risk: a Pooled Analysis of 9 Cohorts. Am J Clin Nutr. 2004;80(6):1508-20. PubMed PMID: 15585762.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts. AU - Knekt,Paul, AU - Ritz,John, AU - Pereira,Mark A, AU - O'Reilly,Eilis J, AU - Augustsson,Katarina, AU - Fraser,Gary E, AU - Goldbourt,Uri, AU - Heitmann,Berit L, AU - Hallmans,Göran, AU - Liu,Simin, AU - Pietinen,Pirjo, AU - Spiegelman,Donna, AU - Stevens,June, AU - Virtamo,Jarmo, AU - Willett,Walter C, AU - Rimm,Eric B, AU - Ascherio,Alberto, PY - 2004/12/9/pubmed PY - 2005/1/7/medline PY - 2004/12/9/entrez SP - 1508 EP - 20 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 80 IS - 6 N2 - BACKGROUND: Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear. OBJECTIVE: We studied the relation between the intake of antioxidant vitamins and CHD risk. DESIGN: A cohort study pooling 9 prospective studies that included information on intakes of vitamin E, carotenoids, and vitamin C and that met specific criteria was carried out. During a 10-y follow-up, 4647 major incident CHD events occurred in 293 172 subjects who were free of CHD at baseline. RESULTS: Dietary intake of antioxidant vitamins was only weakly related to a reduced CHD risk after adjustment for potential nondietary and dietary confounding factors. Compared with subjects in the lowest dietary intake quintiles for vitamins E and C, those in the highest intake quintiles had relative risks of CHD incidence of 0.84 (95% CI: 0.71, 1.00; P=0.17) and 1.23 (1.04, 1.45; P=0.07), respectively, and the relative risks for subjects in the highest intake quintiles for the various carotenoids varied from 0.90 to 0.99. Subjects with higher supplemental vitamin C intake had a lower CHD incidence. Compared with subjects who did not take supplemental vitamin C, those who took >700 mg supplemental vitamin C/d had a relative risk of CHD incidence of 0.75 (0.60, 0.93; P for trend <0.001). Supplemental vitamin E intake was not significantly related to reduced CHD risk. CONCLUSIONS: The results suggest a reduced incidence of major CHD events at high supplemental vitamin C intakes. The risk reductions at high vitamin E or carotenoid intakes appear small. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/15585762/Antioxidant_vitamins_and_coronary_heart_disease_risk:_a_pooled_analysis_of_9_cohorts_ DB - PRIME DP - Unbound Medicine ER -