Antioxidant Vitamins and Coronary Artery Disease Risk in South African Males
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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