Elsevier

Clinica Chimica Acta

Volume 278, Issue 1, 1 November 1998, Pages 55-60
Clinica Chimica Acta

Antioxidant Vitamins and Coronary Artery Disease Risk in South African Males

https://doi.org/10.1016/S0009-8981(98)00131-4Get rights and content

Abstract

Decreased antioxidant–vitamin nutritional status may increase lipid peroxidation and susceptibility of low-density lipoprotein (LDL) to oxidative modification. The aim of this study was to evaluate the vitamin nutritional status of coronary artery disease (CAD) patients and to assess the risk of CAD related to each individual antioxidant vitamin. The study was performed as a case-control study with 41 patients with angiographically demonstrated CAD and 41 apparently healthy age- and smoking status-matched controls. Plasma vitamin E, C and A concentrations were significantly decreased in CAD patients compared with controls (p<0.001) after correcting for significant covariates. Per quartile decrease in vitamin A and E concentrations was associated with increased risk of CAD, even after adjusting for CAD risk factors, while per quartile decrease in vitamin C concentrations was not associated with significant CAD risk after adjusting for CAD risk factors. Decreased vitamin A and E concentrations are independently associated with increased risk of CAD independent from other CAD risk factors in white male South Africans and dietary intervention strategies are advocated.

Section snippets

Introduction.

An increasing amount of scientific evidence suggests that vitamin nutritional status may be an important determinant of cardiovascular disease risk. Vitamin deficiencies may accelerate atherogenesis by promoting LDL peroxidation [1]. Foam-cell formation follows unregulated uptake of structurally modified LDL by scavenger receptors expressed on macrophages in the sub-endothelial space [1]. Antioxidants within the LDL particle, and in the circulation, presumably protect the LDL particle against

Patients and controls

Ethical approval was granted by the Human Ethics Committee of the University of Pretoria to perform a serial study on male patients with symptoms of coronary artery disease admitted to the Pretoria Heart Hospital. From a group of 58 patients with angiographically proven cardiovascular disease (CAD) and 98 apparently healthy controls, 41 pairs matched for age and smoking status were selected. The median (range) age of the patients and controls was 51 (26–62) years and 50 (26–58) years

Results

The CAD risk profile of patients and controls subjects, are reported in Table 1. Twenty-four percent of patients and controls were current smokers. No significant difference was observed in the prevalence of hypertension (diastolic blood pressure >95 mmHg and systolic blood pressure >160 mmHg or treated with anti-hypertensive drugs) between the two groups, whereas hypercholesterolemia (treatment with cholesterol reducing agents) was significantly more prevalent in patients compared with

Discussion.

Aggressive cholesterol lowering in the patient group resulted in lower total cholesterol and LDL cholesterol concentrations, while the apolipoprotein concentrations were significantly more favourable in controls (Table 1). All three of the mayor antioxidant vitamins were significantly decreased in CAD patients compared with controls (Table 2), and associated with increased CAD risk when calculated as crude odds ratios. Decreased vitamin A and E concentrations were independently associated with

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