CLINICAL STUDIES
Oral vitamin C and endothelial function in smokers: short-term improvement, but no sustained beneficial effect
Olli T. Raitakari, MD, PhD*  ,
Mark R. Adams, MB, BS, PhD, FRACP*,
Robyn J. McCredie, BSc*,
Kaye A. Griffiths, DMU*,
Roland Stocker, PhD and
David S. Celermajer, MB, BS, PhD, FRACP*
* Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
Heart Research Institute, Sydney, Australia
Department of Clinical Physiology, University of Turku, Turku, Finland
Manuscript received July 2, 1999;
revised manuscript received November 30, 1999,
accepted January 14, 2000.
Reprint requests and correspondence: Dr. David S. Celermajer, Department of Cardiology, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Sydney, Australia
davidc{at}card.rpa.cs.nsw.gov.au
OBJECTIVES
To test the hypothesis that antioxidant therapy would improve endothelial function in smokers.
BACKGROUND
Several studies have documented a beneficial effect of short-term oral or parenteral vitamin C on endothelial physiology in subjects with early arterial dysfunction. Possible long-term effects of vitamin C on endothelial function, however, are not known.
METHODS
We studied the effects of short- and long-term oral vitamin C therapy on endothelial function in 20 healthy young adult smokers (age 36 ± 6 years, 8 male subjects, 21 ± 10 pack-years). Each subject was studied at baseline, 2 h after a single dose of 2 g vitamin C and 8 weeks after taking 1 g vitamin C daily, and after placebo, in a randomized double-blind crossover study. Blood samples were analyzed for plasma ascorbate levels and endothelial function was measured as flow-mediated dilation of the brachial artery, using high resolution ultrasound. Nitroglycerin-mediated dilation (endothelium-independent) was also measured at each visit.
RESULTS
At baseline, plasma ascorbate level was low in the smokers (42 ± 21 µmol/liter; normal range, 50 to 150 µmol/liter), increased with vitamin C therapy after 2 h to 120 ± 54 µmol/liter (p < 0.001) and remained elevated after eight weeks of supplementation at 92 ± 32 µmol/liter (p < 0.001, compared with placebo). Flow-mediated dilation, however, increased at 2 h (from 2.8 ± 2.0% to 6.3 ± 2.8%, p < 0.001), but there was no sustained beneficial effect after eight weeks (3.9 ± 3.2%, p = 0.26). Nitroglycerin-mediated dilation was unchanged throughout.
CONCLUSION
Oral vitamin C therapy improves endothelial dysfunction in the short term in healthy young smokers, but it has no beneficial long-term effect, despite sustained elevation of plasma ascorbate levels.
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Abbreviations and Acronyms
| | ANOVA | = analysis of variance | | FMD | = flow-mediated dilation | | HDL | = high-density lipoprotein | | LDL | = low-density lipoprotein |
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