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J Am Coll Cardiol, 2003; 42:246-252, doi:10.1016/S0735-1097(03)00575-8 © 2003 by the American College of Cardiology Foundation |
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* Department of Medicine, Children’s Hospital, Boston, Massachusetts, USA
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
|| Channing Laboratory, Boston, Massachusetts, USA
¶ Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Manuscript received August 5, 2002; revised manuscript received November 25, 2002, accepted December 12, 2002.
* Reprint requests and correspondence: Dr. Stavroula K. Osganian, Clinical Research Program, Children’s Hospital, 333 Longwood Avenue, Boston, Massachusetts 02115, USA.
stavroula.osganian{at}TCH.harvard.edu
OBJECTIVES: Our objective was to prospectively examine the relation between vitamin C intake and risk of coronary heart disease (CHD) in women.
BACKGROUND: Results from prospective investigations of the relation between vitamin C intake and risk of CHD have been inconsistent. The lack of clear evidence for a protective association despite a plausible mechanism indicates the need to evaluate further the association between vitamin C intake and risk of CHD.
METHODS: In 1980, 85,118 female nurses completed a detailed semiquantitative food-frequency questionnaire that assessed their consumption of vitamin C and other nutrients. Nurses were followed up for 16 years for the development of incident CHD (nonfatal myocardial infarction and fatal CHD).
RESULTS: During 16 years of follow-up (1,240,566 person-years), we identified 1,356 incident cases of CHD. After adjustment for age, smoking, and a variety of other coronary risk factors, we observed a modest significant inverse association between total intake of vitamin C and risk of CHD (relative risk [RR] = 0.73; 95% confidence interval [CI] 0.57 to 0.94). Among women who did not use vitamin C supplements or multivitamins, the association between intake of vitamin C from diet alone and incidence of CHD was weak and not significant (RR = 0.86; 95% CI 0.59 to 1.26). In multivariate models adjusting for age, smoking, and a variety of other coronary risk factors, vitamin C supplement use was associated with a significantly lower risk of CHD (RR = 0.72; 95% CI 0.61 to 0.86).
CONCLUSIONS: Users of vitamin C supplements appear to be at lower risk for CHD.
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