Positive Health Online

Abstract

SALONEN and co-workers, Research Institute of Public Health, University of Kuopio, Kuopio, Finland, and Department of Clinical Pharmacology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, jukka.salonen@uku.fi, conducted a randomized controlled trial of antioxidant supplementation in the prevention of atherosclerosis.

Background

The aim of the study was to examine the effects of vitamins C and E on the progression of carotid atherosclerosis, and to test the hypothesis that there would be a protective effect in men and in smokers, and that a synergism between the two vitamins could be shown.

Methodology

This was a double-blinded two-by-two factorial trial with randomization in four strata (by gender and smoking status). 520 smoking and nonsmoking men and postmenopausal women aged between 45 and 69 years were divided into four groups receiving two daily doses of either 91 mg of vitamin E, 250 mg of vitamin C, both, or a placebo for three years. Atherosclerotic progression, defined as the linear regression slope of carotid artery mean intima-media thickness (IMT) as assessed by ultrasound, was calculated over 6-monthly assessments.

Results

The average increase of mean IMT was 0.020 mm per year in men randomized to placebo, 0.018 mm per year in the vitamin E group, 0.017 mm per year in the vitamin C group, and 0.011 mm per year in the group on both vitamins (p = 0.008 for combination vs placebo groups). The respective figures in women are 0.016, 0.015, 0.017, and 0.016 mm per year. The proportion of men with progressive thickening of the carotid artery was reduced by 74% (p = 0.003) by supplementation with both vitamins C and E as compared with placebo.

Conclusion

The study shows that a combined supplementation with reasonable doses of vitamins C and E can retard the progression of atherosclerosis in men. These results may imply benefits with regard to atherosclerosis-related diseases and mortality.

References

Salonen JT, Nyyssoenen K, Salonen R, Lakka HM, Kaikkonen J, Porkkala-Sarataho E, Voutilainen S, Lakka TA, Rissanen T, Leskinen L, Tuomainen TP, Valkonen VP, Ristonmaa U, Poulsen HE. Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study: a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis. Journal of Internal Medicine 248 (5): 377-386, Nov 2002.

Comment

This is a study of impressive scope with results that show the potential health benefits of multivitamin supplementation upon patients with atherosclerosis. What a pity that the EU Directive may lower the dosages available of nutrients such as vitamins C and E.