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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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CLINICAL RESEARCH: ATHEROSCLEROSIS RISK

Vitamin C and risk of coronary heart disease in women

Stavroula K. Osganian, MD*,*, Meir J. Stampfer, MD{dagger}{ddagger}||, Eric Rimm, ScD{dagger}{ddagger}||, Donna Spiegelman, ScD{ddagger}§||, Frank B. Hu, MD{dagger}, JoAnn E. Manson, MD{ddagger}||¶ and Walter C. Willett, MD{dagger}{ddagger}||

* Department of Medicine, Children’s Hospital, Boston, Massachusetts, USA
{dagger} Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
{ddagger} 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.

Abbreviations and Acronyms
  CHD = coronary heart disease
  CI = confidence interval
  MI = myocardial infarction
  RR = relative risk
  SFFQ = semiquantitative food-frequency questionnaire




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