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Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Recently, much public and scientific interest has been directed toward the role of vitamins and other nutrients in health promotion and disease prevention. It is estimated that 40% of the US population takes vitamin supplements (1) in varying doses to prevent or treat diseases, such as cardiovascular disease (CVD) and cancer. Vitamins have significant health effects beyond preventing deficiency diseases, namely their antioxidant functions. In this chapter, the role of vitamin therapy for CVD is reviewed; the evidence affecting cardiovascular health is also discussed. The vitamins included in the discussion are vitamins E, C, B6, B12, folic acid, niacin, and beta-carotene.

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References

  1. Food and Drug Administration. Dietary supplements. Available at: http:// www.fda.gov. Accessed.

    Google Scholar 

  2. Subcommittee on the Tenth Edition of the RDAs. Food and Nutrition Board, Commission on Life Sciences, National Research Council. National Academy Press, 1989.

    Google Scholar 

  3. Steinberg D, Parthasarathy S, Carew TE, Khoo JD, Witztum JL. Beyond cholesterol: modifications of low density lipoproteins that increase its atherogenicity. N Engl J Med 1989; 320: 915–924.

    Article  PubMed  CAS  Google Scholar 

  4. Rong JX, Rangaswamy S, Shen L, Dave R, Chang YH, Peterson H. Arterial injury by cholesterol oxidation products causes endothelial dysfunction and arterial wall cholesterol accumulation. Arterioscl Thromb Vasc Biol 1998; 18: 1885–1894.

    Article  PubMed  CAS  Google Scholar 

  5. Bjorkhem I, Henriksson-Freyschuss A, Breuer O, Diczfalusy U, Berglund L, Henriksson P. The antioxidant butylated hydroxytoluene protects against atherosclerosis. Arterioscl Thromb 1991; 11: 15–22.

    Article  PubMed  CAS  Google Scholar 

  6. Diaz MN, Frei B, Vita JA, Keaney JF. Antioxidants and atherosclerotic heart disease. N Engl J Med 337: 408–416.

    Google Scholar 

  7. Gey KF, Brubacher GB, Stahelin HB. Plasma levels of antioxidant vitamins in relation to ischemic heart disease and cancer. Am J Clin Nutr 1987; 45: 1368–1377.

    PubMed  CAS  Google Scholar 

  8. Enstrom JE, Karim LE, Klein MA. Vitamin C intake and mortality among a sample of theunited States population. Epidemiology 1992; 3: 194–202.

    Article  PubMed  CAS  Google Scholar 

  9. Khaw KT, Bingham S, Welch A, et al. Relation between plasma ascorbic acid and mortality in men and women in EPIC-Norfolk prospective study: a prospective population study. Lancet 2001; 357: 657–663.

    Article  PubMed  CAS  Google Scholar 

  10. Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Ying W, BostickW. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 1996; 334: 1156–1162.

    Article  PubMed  CAS  Google Scholar 

  11. Rimm EB, Stampher MJ, Ascherio A, et al. Vitamin E consumption and the risk of coronary disease in men. N Engl J Med 193; 328: 145–146.

    Google Scholar 

  12. Food and Nutrition Board, Institute of Medicine. A Report of the Panel on Dietary Antioxidants and Related Compounds. Dietary Reference Intakes for Vitamin C, Vitamin E, Vitamin C, Selenium and Carotenoids. National Academy Press, Washington, DC, 2000.

    Google Scholar 

  13. Stampfer MJ, Hennekens CH, Manson JE, et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993; 328: 1444–1449.

    CAS  Google Scholar 

  14. Miwa K, Miyagi Y, Igawa A, Nakagawa K, Inoue A. Vitamin E deficiency in variant angina. Circulation 1996; 94: 14–18

    CAS  Google Scholar 

  15. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study Group. The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330: 1029–1035.

    Google Scholar 

  16. Virtamo J, Rapola JM, Ripatti S, et al. Effects of vitamin E and beta-carotene on the incidence of primary nonfatal myocardial infection and fatal coronary heart disease. Arch Intern Med 1998; 158: 668–675.

    CAS  Google Scholar 

  17. Stephens NG, Parson A, Schofield PM, Kelly F, Cheeseman K, Mitchinson MJ. Randomised controlled trial of vitamin E in patients with coronary disease. Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996; 347: 781–786.

    CAS  Google Scholar 

  18. The HOPE (Heart Outcomes Prevention Evaluation) Study Investigators. Vitamin E supplementation and cardio-vascular events in high-risk patients. N Engl J Med 2000; 342: 154–160.

    Google Scholar 

  19. Lonn EM, Yusuf S, Dzavik V, et al for the SECURE Investigators. Effects of ramipril and vitamin E on atherosclerosis. Circulation 2001; 103: 919–925.

    CAS  Google Scholar 

  20. GISSI-PrevenzioneInvestigators(GruppoItalianoperloSudiodellaSopravvivenze nell’infarto Miocardico). Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI- Prevenzione trial. Lancet 1999; 354: 447–455.

    Google Scholar 

  21. MRC/BHF Heart Protection Study Collaborative Group, MRC/BHF Heart Protection Study of cholesterol-lowering therapy and of antioxidant vitamin supplementation in a wide range of patients at increased risk of coronary heart disease death: early safety and efficacy experience. Eur Heart J 1999; 20: 725–741. Lancet 2002;360:23–33.

    Article  Google Scholar 

  22. Steinberg D. Cinical trials of antioxidants in atherosclerosis: are we doing the right things? Lancet 1995; 349: 36–38.

    Article  Google Scholar 

  23. Collaborative group of the Primary Prevention Project. Low dose aspirin and vitamin E in people at cardiovascular risk: a randomized trial in general practice. Lancet 2001; 357: 89–95.

    Google Scholar 

  24. halal I, Norkus E, Cristol I, Grundy SM. Beta carotene inhibits the oxidative modifications of low-density lipoprotein. Biochem Biophys Acta 1991; 1086: 134–138.

    Article  Google Scholar 

  25. Hennekens CH, Buning JE, Manson JE. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996; N334: 1145–1149.

    Article  PubMed  CAS  Google Scholar 

  26. Omenn GS, Goodman E, Thomquist MD, et al. Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 1996; 334: 1150–1155.

    Article  PubMed  CAS  Google Scholar 

  27. van Poppel G, Kardinaal A, Princen H, Kok FJ. Antioxidants and coronary heart disease. Ann Med 1994; 26: 429–434

    Article  PubMed  Google Scholar 

  28. Kuller LH, Evans RW. Homocysteine, vitamins and cardiovascular disease. Circulation 1998; 98: 196–199.

    Article  PubMed  CAS  Google Scholar 

  29. Stampfer MJ, Malinow MR, Willett WCE. A prospective study of plasma homocyt(e)ine and risk of myocardial infarction in US physicians. JAMA 1992; 268: 877–881.

    Article  PubMed  CAS  Google Scholar 

  30. Rimin EB, Willett WC, Hu FB. Folate and vitamin B6 from diet and supplement in relation to risk of coronary heart disease among women. JAMA 1998; 279: 359–364.

    Article  Google Scholar 

  31. Voutilainen S, Rissanen TH, Virtanen J, Lakka TA, Salonen JT. Low dietary Folate intake is associated with an excess incidence of acute coronary events. Circulation 2001; 103: 2674–2680.

    Article  PubMed  CAS  Google Scholar 

  32. Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Fed Register 1996;61:8781–8797.

    Google Scholar 

  33. Tucker KL, Mahnken B, Wilson PW, Jacques P, Selhub J. Folic acid fortification of the food supply. Potential benefits and risks for the elderly population. JAMA 1996; 276: 1879–1885.

    Article  PubMed  CAS  Google Scholar 

  34. Malinow MR, Duell PB, Hess DL, Anderson PH, Kruger WD, Phillipson BE, Gluckman RA, Block PC, and Upson BM. Reduction of plasma homocysteine levels by breafast cereal fortified with folic acid in patients with coronary heart disease. N. Engl. J Med. 1998; 338: 1009–1015.

    CAS  Google Scholar 

  35. Jacques PF, Selhub J, Boston AG, Wilson PW, Rosenberg IH. The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med 1999; 340: 1449–1454

    Article  PubMed  CAS  Google Scholar 

  36. Usui M, Matsuoka H, Miyazaki H, Ueda S, Okuda S, Imaizum T. Endothelial dysfunction by acute hyperhomocysteinemia restoration by folic acid. Clin Sci 1999; 96: 235–239.

    Article  PubMed  CAS  Google Scholar 

  37. Wilmink HW, Stroes ESG, Erkelens WD, et al. Influence of folic acid on postprandial endothelial dysfunction. Arterioscl Thromb Vasc Biol 2000; 20: 185–188.

    Article  PubMed  CAS  Google Scholar 

  38. Pullin CH, Ashfield-Watt PA, Burr ML, et al. Optimization of dietary folate or low dose folic acid supplements lower homocysteine but do not enhance endothelial function in healthy adults, irrespective of the methylenetetrahydrofolate reductase (C677T) genotype. J Am Coll Cardiol 2001; 38: 1799–1805.

    Article  PubMed  CAS  Google Scholar 

  39. Nakano E, Higgins JA, Powers HJ. Short communication. Folate protects against oxidative modification of human LDL. Br J Nutr 2001; 86: 637–639.

    Article  PubMed  CAS  Google Scholar 

  40. Schnyder G, Roffi M, Pin R, et al. Decreased rate of coronary restenosis with lowering of plasma homocysteine levels. N Engl J Med 2001; 345: 1593–1600.

    Article  PubMed  CAS  Google Scholar 

  41. Schnyder G, Roffi M, Hammer Y, et al. Effect of homocysteine-lowering therapy with folic acid, vitamin B12 and vitamin B6 on clinical outcome after percutaneous coronary intervention. JAMA 2002; 288: 973–979.

    Article  PubMed  CAS  Google Scholar 

  42. Genser D, Pracher H, Hauer R, et al. Relation of homocysteine, vitamin B12 and folate to coronary in-stent restenosis. Am J Cardiol 2002; 89: 495–499.

    Article  PubMed  CAS  Google Scholar 

  43. Brown AA, Hu FB. Dietary modulation of endothelial function: implications for cardiovascular disease. Am J Clin Nutr 2001; 73: 673–686.

    PubMed  CAS  Google Scholar 

  44. Katz DL, Nawaz H, Boukhalil J, et al. Acute effects of oats and vitamin E on endothelial responses to ingested fat. Am J Prey Med 2001; 20: 124–129.

    CAS  Google Scholar 

  45. Chambers JC, McGregor A, Jean-Marie J, Obeid OA, Kooner JS. Demonstration of rapid onset vascular endothelial function after hyperhomocysteinemia: an effect reversible with vitamin C therapy. Circulation 1999; 99: 1156–1160.

    Article  PubMed  CAS  Google Scholar 

  46. Skyrme-Jones RA, O’Brien OC, Berry KL, Meredith IT. Vitamin E supplementation improves endothelial function in type 1 diabetes mellitus: a randomized, placebo-controlled study. J Am Coll Cardiol 2000; 36: 94–102.

    CAS  Google Scholar 

  47. Kugiyama K, Motoyama T, Doi H, et al. Improvement of endothelial vasomotor dysfunction by treatment with alpha-tocopherol in patients with high remnant lipoprotein levels. J Am Coll Cardiol 1999; 33: 1512–1518.

    Article  PubMed  CAS  Google Scholar 

  48. Richartz BM, Werner GS, Ferrari M, Figulla HR. Reversibility of coronary endothelial vasomotor dysfunction in idiopathic dilated cardiomyopathy; acute effects of vitamin C. Am J Cardiol 2001; 88: 10001–1005.

    Article  Google Scholar 

  49. Rossig L, Hoffmann J, Hugel B, et al. Vitamin C inhibits endothelial cell apoptosis in congestive heart failure. Circulation 2001; 104: 2181–2187.

    Article  Google Scholar 

  50. Fang JC, Kinlay S, Beltrame J, et al. Effect of vitamins C and E on Progression of transplant associated arteriosclerosis: a randomized trial. Lancet 2002; 359: 1108–1113.

    CAS  Google Scholar 

  51. McKechnie R, Rubenfire M, Mosca L. Antioxidant nutrient supplementation and brachial reactivity in patients with coronary artery disease. Lab Clin Med 2002; 139; 133–139.

    Article  CAS  Google Scholar 

  52. Canner PL, Berge KG,Winger NK, et al. Fifteen year mortality in Coronary Drug Project patients: long term benefits with niacin. J Am Coll Cardiol 1986; 8: 1245–1255.

    Article  PubMed  CAS  Google Scholar 

  53. Schectman G, Hiatt A. Evaluation of the effectiveness of lipid lowering therapy (bile acid sequestrants, niacin, psyllium and lovastatin) for treating hypercholesterolemia in veterans. Am J Cardiol 1993; 71: 758–765.

    Article  Google Scholar 

  54. Ellingworth DR, Stein EA, Mitchell YB, et al. Comparative effects of lovastatin and niacin in primary hypercholesterolemia: a prospective trial. Arch Intern Med 1994; 154: 1586–1595.

    Article  Google Scholar 

  55. Davignon J, Raederer G, Montigny M, et al. Comparative efficacy and safety of pravastatin, nicotinic acid and the two combined in patients with hypercholesterolemia. Am J Cardiol 1994; 73: 339–345.

    Article  PubMed  CAS  Google Scholar 

  56. Jokubaitis LA. Fluvastatin in combination and other lipid-lowering agents. BrJ Clin Pract 1996; 77A (suppl): 28–32.

    Google Scholar 

  57. Jacobson TA, Chin MM, Fromel GJ, Jokubaitis LA, Amorosa LF. Fluvastatin with and without niacin for hypercholesterolemia. Am J Cardiol 1994; 74: 149–154.

    Article  PubMed  CAS  Google Scholar 

  58. Vacek JL, Dittmeier G, Chiarelli T, White J, Bell JJ. Comparison of lovastatin (20mg) and nicotinic acid (1.2) with either drug for type 11 hyperlipidemia. Am J Cardiol 1995; 76: 182–184

    Article  PubMed  CAS  Google Scholar 

  59. Wink J, Giacoppe G, King J. Effect of very-low-dose niacin on high-density lipoprotein in patients undergoing long-term statin therapy. Am Heart J 2002; 143: 514–518.

    Article  PubMed  CAS  Google Scholar 

  60. Institute of Medicine Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. National Academy Press, Washington, DC, 2000.

    Google Scholar 

  61. Cheung MC, Zhao XQ, Chait A, Albers JJ, Brown G. Antioxidant supplements block the response of HDL to Simvastatin-Niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001; 21; 1320–1326.

    Article  PubMed  CAS  Google Scholar 

  62. Muntwyler J, Hennekens CH, Manson JE, Buring JE, Gaziano JM. Vitamin supplement use in a low risk population of US male physicians and subsequent cardiovascular mortality. Arch Intern Med 2002; 162: 1472–1476.

    Article  PubMed  Google Scholar 

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© 2004 Humana Press Inc., Totowa, NJ

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Karmally, W. (2004). Vitamin Therapy for Cardiovascular Disease. In: Stein, R.A., Oz, M.C. (eds) Complementary and Alternative Cardiovascular Medicine. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-728-4_5

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  • DOI: https://doi.org/10.1007/978-1-59259-728-4_5

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9831-8

  • Online ISBN: 978-1-59259-728-4

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