Skip to main content

Antioxidant and B-vitamins and Atherosclerosis

  • Chapter
  • First Online:
Preventive Nutrition

Abstract

Cardiovascular disease (CVD) is the main cause of death in Western countries. It is well accepted that high intake of fruits and vegetables has a significant role in the prevention of many chronic diseases such as CVD, cancer, and degenerative brain disorders (1). Due to the complexity of the nutrient content of fruits and vegetables, identification of specific nutrients responsible for cardioprotection is challenging. Collectively, the likely substances that provide the beneficial effects of fruits and vegetables include antioxidant vitamins and B-vitamins.

Key Points

Atherosclerosis is an interlinked inflammatory free-radical process.

Observational studies suggest that antioxidant and B-vitamins may reduce cardiovascular disease.

Randomized controlled trials have not substantiated a reduction in cardiovascular disease with antioxidant or B-vitamin supplementation.

Randomized controlled trials raise a level of concern for the safety of certain antioxidant vitamin supplementation under certain conditions.

Current data do not support the use of antioxidant or B-vitamin supplementation for the prevention or treatment of cardiovascular disease.

Consumption of fruits and vegetables high in antioxidant and B-vitamins appears to be an important component of a healthy dietary intake and lifestyle.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 239.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ignarro, L. J., Balestrieri, M. L., and Napoli, C. (2007) Nutrition, physical activity, and cardiovascular disease: an update. Cardiovasc Res 73, 326–40.

    CAS  PubMed  Google Scholar 

  2. Faxon, D. P., Fuster, V., Libby, P., Beckman, J. A., Hiatt, W. R., Thompson, R. W., Topper, J. N., Annex, B. H., Rundback, J. H., Fabunmi, R. P., Robertson, R. M., Loscalzo, J., and American Heart Association. (2004) Atherosclerotic Vascular Disease Conference: Writing Group III: pathophysiology. Circulation 109, 2617–25.

    PubMed  Google Scholar 

  3. Madamanchi, N. R., Vendrov, A., and Runge, M. S. (2005) Oxidative stress and vascular disease. Arterioscler Thromb Vasc Biol 25, 29–38.

    CAS  PubMed  Google Scholar 

  4. Rong, J. X., Rangaswamy, S., Shen, L., Dave, R., Chang, Y. H., Peterson, H., Hodis, H. N., Chisolm, G. M., and Sevanian, A. (1998) Arterial injury by cholesterol oxidation products causes endothelial dysfunction and arterial wall cholesterol accumulation. Arterioscler Thromb Vasc Biol 18, 1885–94.

    CAS  PubMed  Google Scholar 

  5. Björkhem, I., Henriksson-Freyschuss, A., Breuer, O., Diczfalusy, U., Berglund, L., and Henriksson, P. (1991) The antioxidant butylated hydroxytoluene protects against atherosclerosis. Arterioscler Thromb 11, 15–22.

    PubMed  Google Scholar 

  6. Hodis, H. N., Chauhan, A., Hashimoto, S., Crawford, D. W., and Sevanian, A. (1992) Probucol reduces plasma and aortic wall oxysterol levels in cholesterol fed rabbits independently of its plasma cholesterol lowering effect. Atherosclerosis 96, 125–34.

    CAS  PubMed  Google Scholar 

  7. Stringer, M. D., Görög, P. G., Freeman, A., and Kakkar, V. (1989) Lipid peroxides and atherosclerosis. BMJ 298, 281–4.

    CAS  PubMed  Google Scholar 

  8. Azen, S. P., Qian, D., Mack, W. J., Sevanian, A., Selzer, R. H., Liu, C. R., Liu, C. H., and Hodis, H. N. (1996) Effect of supplementary antioxidant vitamin intake on carotid arterial wall intima-media thickness in a controlled clinical trial of cholesterol lowering. Circulation 94, 2369–72.

    CAS  PubMed  Google Scholar 

  9. Hodis, H. N., Mack, W. J., LaBree, L., Cashin-Hemphill, L., Sevanian, A., Johnson, R., and Azen, S. P. (1995) Serial coronary angiographic evidence that antioxidant vitamin intake reduces progression of coronary artery atherosclerosis. JAMA 273, 1849–54.

    CAS  PubMed  Google Scholar 

  10. Thomson, M. J., Puntmann, V., and Kaski, J. C. (2007) Atherosclerosis and oxidant stress: the end of the road for antioxidant vitamin treatment? Cardiovasc Drugs Ther 21, 195–210.

    CAS  PubMed  Google Scholar 

  11. Griendling, K. K., and FitzGerald, G. A. (2003) Oxidative stress and cardiovascular injury: part II: animal and human studies. Circulation 108, 2034–40.

    PubMed  Google Scholar 

  12. Harrison, D., Griendling, K. K., Landmesser, U., Hornig, B., and Drexler, H. (2003) Role of oxidative stress in atherosclerosis. Am J Cardiol 91, 7A–11A.

    CAS  PubMed  Google Scholar 

  13. Lum, H., and Roebuck, K. A. (2001) Oxidant stress and endothelial cell dysfunction. Am J Physiol Cell Physiol 208, C719–41.

    Google Scholar 

  14. Harrison, D. G. (1997) Endothelial function and oxidant stress. Clin Cardiol 20, II-11–7.

    Google Scholar 

  15. Bonetti, P. O., Lerman, L. O., and Lerman, A. (2003) Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol 23, 168–75.

    CAS  PubMed  Google Scholar 

  16. Nedeljkovic, Z. S., Gokce, N., and Loscalzo, J. (2003) Mechanisms of oxidative stress and vascular dysfunction. Postgrad Med J 79, 195–9.

    CAS  PubMed  Google Scholar 

  17. Uchida, K. (2007) Lipid peroxidation and redox-sensitive signaling pathways. Curr Atheroscler Rep 9, 216–21.

    CAS  PubMed  Google Scholar 

  18. Torzewski, M., and Lackner, K. J. (2006) Initiation and progression of atherosclerosis—enzymatic or oxidative modification of low-density lipoprotein? Clin Chem Lab Med 44, 1389–94.

    CAS  PubMed  Google Scholar 

  19. Griendling, K. K., Sorescu, D., and Ushio-Fukai, M. (2000) NAD(P)H oxidase, role in cardiovascular biology and disease. Circ Res 86, 494–501.

    CAS  PubMed  Google Scholar 

  20. Urso, M. L., and Clarkson, P. M. (2003) Oxidative stress, exercise, and antioxidant supplementation. Toxicology 189, 41–54.

    CAS  PubMed  Google Scholar 

  21. Bonomini, F., Tengattini, S., Fabiano, A., Bianchi, R., and Rezzani, R. (2008) Atherosclerosis and oxidative stress. Histol Histopathol 23, 381–90.

    CAS  PubMed  Google Scholar 

  22. Traber, M. G. (2007) Heart disease and single-vitamin supplementation. Am J Clin Nutr 85, 293S–9S.

    CAS  PubMed  Google Scholar 

  23. Singh, U., Devaraj, S., and Jialal, I. (2005) Vitamin E, oxidative stress, and inflammation. Annu Rev Nutr 25, 151–74.

    CAS  PubMed  Google Scholar 

  24. Meydani, M. (2004) Vitamin E modulation of cardiovascular disease. Ann N Y Acad Sci 1031, 271–9.

    CAS  PubMed  Google Scholar 

  25. Nishikimi, M., and Yagi, K. (1996) Biochemistry and molecular biology of ascorbic acid biosynthesis. Subcell Biochem 25, 17–39.

    CAS  PubMed  Google Scholar 

  26. Haytowitz, D. B. (1995) Information from USDA’s nutrient data bank. J Nutr 125, 1952–5.

    CAS  PubMed  Google Scholar 

  27. Tolbert, B. M. (1985) Metabolism and function of ascorbic acid and its metabolites. Int J Vitam Nutr Res Suppl 27, 121–68.

    CAS  PubMed  Google Scholar 

  28. Di Mascio, P., Kaiser, S., and Sies, H. (1989) Lycopene as the most efficient biological carotenoid singlet oxygen quencher. Arch Biochem Biophys 274, 532–8.

    PubMed  Google Scholar 

  29. Tapiero, H., Townsend, D. M., and Tew, K. D. (2004) The role of carotenoids in the prevention of human pathologies. Biomed Pharmacother 58, 100–10.

    CAS  PubMed  Google Scholar 

  30. Berliner, J. A., and Heineicke, J. W. (1996) The role of oxidized lipoproteins in atherogenesis. Free Rad Biol Med 20, 707–27.

    CAS  PubMed  Google Scholar 

  31. Suzuki, Y. J., Forman, H. J., and Sevanian, A. (1997) Oxidants as stimulators of signal transduction. Free Radic Biol Med 22, 269–85.

    CAS  PubMed  Google Scholar 

  32. Ricciarelli, R., Tasinato, A., Clément, S., Ozer, N. K., Boscoboinik, D., and Azzi, A. (1998) Alpha-Tocopherol specifically inactivates cellular protein kinase C alpha by changing its phosphorylation state. Biochem J 334, 243–9.

    CAS  PubMed  Google Scholar 

  33. McCully, K. S. (1969) Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis. Am J Pathol 56, 111–28.

    CAS  PubMed  Google Scholar 

  34. Heart Study Collaboration. (2002) Homocysteine Studies Collaboration. JAMA 288, 15–22.

    Google Scholar 

  35. Wald, D. S., Law, M., and Morris, J. K. (2002) Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ 325, 1202–6.

    PubMed  Google Scholar 

  36. Mangoni, A. A., and Jackson, S. H. (2002) Homocysteine and cardiovascular disease: current evidence and future prospects. Am J Med 112, 556–65.

    CAS  PubMed  Google Scholar 

  37. Malinow, M. R., Nieto, F. J., Kruger, W. D., Duell, P. B., Hess, D. L., Gluckman, R. A., Block, P. C., Holzgang, C. R., Anderson, P. H., Seltzer, D., Upson, B., and Lin, Q. R. (1997) The effects of folic acid supplementation on plasma total homocysteine are modulated by multivitamin use and methylenetetrahydrofolate reductase genotypes. Arterioscler Thromb Vasc Biol 17, 1157–62.

    CAS  PubMed  Google Scholar 

  38. Papatheodorou, L., and Weiss, N. (2007) Vascular oxidant stress and inflammation in hyperhomocysteinemia. Antioxid Redox Signal 9, 1941–58.

    CAS  PubMed  Google Scholar 

  39. Moens, A. L., Vrints, C. J., Claeys, M. J., Timmermans, J. P., Champion, H. C., and Kass, D. A. (2008) Mechanisms and potential therapeutic targets for folic acid in cardiovascular disease. Am J Physiol Heart Circ Physiol 294, H1971–7.

    CAS  PubMed  Google Scholar 

  40. Stehouwer, C. D., and van Guldener, C. (2003) Does homocysteine cause hypertension? Clin Chem Lab Med 41, 1408–11.

    CAS  PubMed  Google Scholar 

  41. Sauls, D. L., Arnold, E. K., Bell, C. W., Allen, J. C., and Hoffman, M. (2007) Pro-thrombotic and pro-oxidant effects of diet-induced hyperhomocysteinemia. Thromb Res 120, 117–26.

    CAS  PubMed  Google Scholar 

  42. Verlangieri, A. J., Kapeghian, J. C.,el-Dean, S., and Bush, M. (1985) Fruit and vegetable consumption and cardiovascular mortality. Med Hypotheses 16, 7–15.

    CAS  PubMed  Google Scholar 

  43. Ginter, E. (1979) Decline in coronary mortality in United States and vitamin C. Am J Clin Nutr 32, 511–2.

    CAS  PubMed  Google Scholar 

  44. Acheson, R. M., and Williams, D. R. R. (1993) Does consumption of fruit and vegetables protect against stroke? Lancet 1, 1191–3.

    Google Scholar 

  45. Armstrong, B. K., Mann, J. I., Adelstein, A. M., and Eskin, F. (1975) Commodity consumption and ischemic heart disease mortality, with special reference to dietary practices. J Chron Dis 28, 455–69.

    CAS  PubMed  Google Scholar 

  46. Stampfer, M. J., Hennekens, C. H., Manson, J. E., Colditz, G. A., Rosner, B., and Willett, W. C. (1993) Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 328, 1444–9.

    CAS  PubMed  Google Scholar 

  47. Rimm, E. B., Stampfer, M. J., Ascherio, A., Giovannucci, E., Colditz, G. A., and Willett, W. C. (1993) Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 328, 1450–6.

    CAS  PubMed  Google Scholar 

  48. Knekt, P., Reunanen, A., Järvinen, R., Seppänen, R., Heliövaara, M., and Aromaa, A. (1994) Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol 139, 1180–9.

    CAS  PubMed  Google Scholar 

  49. Losonczy, K. G., Harris, T. B., and Havlik, R. J. (1996) Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons. Am J Clin Nutr 64, 190–6.

    CAS  PubMed  Google Scholar 

  50. Kushi, L. H., Folsom, A. R., Prineas, R. J., Mink, P. J., Wu, Y., and Bostick, R. M. (1996) Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 334, 1156–62.

    CAS  PubMed  Google Scholar 

  51. Yochum, L. A., Folsom, A. R., and Kushi, L. H. (2000) Intake of antioxidant vitamins and risk of death from stroke in postmenopausal women. Am J Clin Nutr 72, 476–83.

    CAS  PubMed  Google Scholar 

  52. Klipstein-Grobusch, K., Geleijnse, J. M., den Breeijen, J. H., Boeing, H., Hofman, A., Grobbee, D. E., and Witteman, J. C. (1999) Dietary antioxidants and risk of myocardial infarction in the elderly. Am J Clin Nutr 69, 261–6.

    CAS  PubMed  Google Scholar 

  53. Enstrom, J. E., Kanim, L. E., and Klein, M. A. (1992) Vitamin C intake and mortality among a sample of the United States population. Epidemiology 3, 194–202.

    CAS  PubMed  Google Scholar 

  54. Enstrom, J. E., Kanim, L. E., and Breslow, L. (1986) The relationship between vitamin C intake, general health practices, and mortality in Alameda County, California. Am J Public Health 76, 1124–30.

    CAS  PubMed  Google Scholar 

  55. Pandey, D. K., Shekelle, R., Selwyn, B. J., Tangney, C., and Stamler, J. (1995) Dietary vitamin C and beta-carotene and risk of death in middle-aged men. Am J Epidemiol 142, 1269–78.

    CAS  PubMed  Google Scholar 

  56. Lapidus, L., Andersson, H., Bengtsson, C., and Bosaeus, I. (1986) Dietary habits in relation to incidence of cardiovascular disease and death in women: a 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. Am J Clin Nutr 44, 444–8.

    CAS  PubMed  Google Scholar 

  57. Gale, C. R., Martyn, C. N., Winter, P. D., and Cooper, C. (1995) Vitamin C and risk of death from stroke and coronary heart disease in cohort of elderly people. BMJ 310, 1563–6.

    CAS  PubMed  Google Scholar 

  58. Shekelle, R. B., Lepper, M., Liu, S., Maliza, C., Raynor, W. J. J., Rossof, A. H., Paul, O., Shryock, A. M., and Stamler, J. (1981) Dietary vitamin A and risk of cancer in the Western Electric study. Lancet 2, 1185–90.

    CAS  PubMed  Google Scholar 

  59. Gaziano, J. M., Manson, J. E., Branch, L. G., Colditz, G. A., Willett, W. C., and Buring, J. E. (1995) A prospective study of consumption of carotenoids in fruits and vegetables and decreased cardiovascular mortality in the elderly. Ann Epidemiol 5, 225–60.

    Google Scholar 

  60. Klipstein-Grobusch, K., Launer, L. J., Geleijnse, J. M., Boeing, H., Hofman, A., and Witteman, J. C. (2000) Serum carotenoids and atherosclerosis. Atherosclerosis 148, 49–56.

    CAS  PubMed  Google Scholar 

  61. Al-Delaimy, W. K., Rexrode, K. M., Hu, F. B., Albert, C. M., Stampfer, M. J., Willett, W. C., and Manson, J. E. (2004) Folate intake and risk of stroke among women. Stroke 35, 1259–63.

    CAS  PubMed  Google Scholar 

  62. He, K., Merchant, A., Rimm, E. B., Rosner, B. A., Stampfer, M. J., Willett, W. C., and Ascherio, A. (2004) Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. Stroke 35, 169–74.

    CAS  PubMed  Google Scholar 

  63. Bazzano, L. A., He, J., Ogden, L. G., Loria, C., Vupputuri, S., Myers, L., and Whelton, P. K. (2002) Dietary intake of folate and risk of stroke in US men and women: NHANES I epidemiologic follow-up study. Stroke 33, 1183–8.

    CAS  PubMed  Google Scholar 

  64. Gey, K. F., Stähelin, H. B., and Eichholzer, M. (1993) Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke. Clin Investig 71, 3–6.

    CAS  PubMed  Google Scholar 

  65. Gey, K. F., Puska, P., Jordan, P., and Moser, U. K. (1991) Inverse correlation between plasma vitamin E and mortality from ischemic heart disease in cross-cultural epidemiology. Am J Clin Nutr 53, 326S–34S.

    CAS  PubMed  Google Scholar 

  66. Gey, K. F., Brubacher, G. B., and Stähelin, H. B. (1987) Plasma levels of antioxidant vitamins in relation to ischemic heart disease and cancer. Am J Clin Nutr 45, 1368–77.

    CAS  PubMed  Google Scholar 

  67. Riemersma, R. A., Oliver, M., Elton, R. A., Alfthan, G., Vartiainen, E., Salo, M., Rubba, P., Mancini, M., Georgi, H., and Vuilleumier, J. P. (1990) Plasma antioxidants and coronary heart disease: vitamins C and E, and selenium. Eur J Clin Nutr 44, 143–50.

    CAS  PubMed  Google Scholar 

  68. Singh, R. B., Ghosh, S., Niaz, M. A., Singh, R., Beegum, R., Chibo, H., Shoumin, Z., and Postiglione, A. (1995) Dietary intake, plasma levels of antioxidant vitamins, and oxidative stress in relation to coronary artery disease in elderly subjects. Am J Cardiol 76, 1233–8.

    CAS  PubMed  Google Scholar 

  69. Simon, J. A., Hudes, E. S., and Browner, W. S. (1998) Serum ascorbic acid and cardiovascular disease prevalence in U.S. adults. Epidemiology 9, 316–21.

    CAS  PubMed  Google Scholar 

  70. Kok, F. J., de Bruijn, A. M., Vermeeren, R., Hofman, A., van Laar, A., de Bruin, M., Hermus, R. J., and Valkenburg, H. A. (1987) Serum selenium, vitamin antioxidants, and cardiovascular mortality: a 9-year follow-up study in the Netherlands. Am J Clin Nutr 45, 432–68.

    Google Scholar 

  71. Salonen, J. T., Salonen, R., Penttilä, I., Herranen, J., Jauhiainen, M., Kantola, M., Lappeteläinen, R., Mäenpää, P. H., Alfthan, G., and Puska, P. (1985) Serum fatty acids, apolipoproteins, selenium and vitamin antioxidants and the risk of death from coronary artery disease. Am J Cardiol 56, 226–31.

    CAS  PubMed  Google Scholar 

  72. Street, D. A., Comstock, G. W., Salkeld, R. M., Schüep, W., and Klag, M. J. (1994) Serum antioxidants and myocardial infarction: are low levels of carotenoids and alpha-tocopherol risk factors for myocardial infarction? Circulation 90, 1154–61.

    CAS  PubMed  Google Scholar 

  73. Riemersma, R. A., Wood, D. A., Macintyre, C. C., Elton, R. A., Gey, K. F., and Oliver, M. F. (1991) Risk of angina pectoris and plasma concentrations of vitamins A, C, and E and carotene. Lancet 337, 1–5.

    CAS  PubMed  Google Scholar 

  74. Morris, D. L., Kritchevsky, S. B., and Davis, C. E. (1994) Serum carotenoids and coronary heart disease. JAMA 272, 1439–41.

    CAS  PubMed  Google Scholar 

  75. Nyyssönen, K., Parviainen, M. T., Salonen, R., Tuomilehto, J., and Salonen, J. T. (1997) Vitamin C deficiency and risk of myocardial infarction: prospective population study of men from eastern Finland. BMJ 314, 634–8.

    PubMed  Google Scholar 

  76. Ramirez, J., and Flowers, N. C. (1980) Leukocyte ascorbic acid and its relationship to coronary artery disease in man. Am J Clin Nutr 33, 2079–87.

    CAS  PubMed  Google Scholar 

  77. Kok, F. J., van Poppel, G., Melse, J., Verheul, E., Schouten, E. G., Kruyssen, D. H., and Hofman, A. (1991) Do antioxidants and polyunsaturated fatty acids have a combined association with coronary atherosclerosis? Atherosclerosis 86, 85–90.

    CAS  PubMed  Google Scholar 

  78. Halevy, D., Thiery, J., Nagel, D., Arnold, S., Erdmann, E., Höfling, B., Cremer, P., and Seidel, D. (1997) Increased oxidation of LDL in patients with coronary artery disease is independent from dietary vitamins E and C. Arterioscler Thromb Vasc Biol 17, 1432–7.

    CAS  PubMed  Google Scholar 

  79. Iribarren, C., Folsom, A. R., Jacobs, D. R. J., Gross, M. D., Belcher, J. D., and Eckfeldt, J. H. (1997) Association of serum vitamin levels, LDL susceptibility to oxidation, and autoantibodies against MDA-LDL with carotid atherosclerosis: a case-control study. Arterioscler Thromb Vasc Biol 17, 1171–7.

    CAS  PubMed  Google Scholar 

  80. Bonithon-Kopp, C., Coudray, C., Berr, C., Touboul, P. J., Fève, J. M., Favier, A., and Ducimetière, P. (1997) Combined effects of lipid peroxidation and antioxidant status on carotid atherosclerosis in a population aged 59–71 years. Am J Clin Nutr 65, 121–7.

    CAS  PubMed  Google Scholar 

  81. Devaraj, S., Tang, R., Adams-Huet, B., Harris, A., Seenivasan, T., de Lemos, J. A., and Jialal, I. (2007) Effect of high-dose alpha-tocopherol supplementation on biomarkers of oxidative stress and inflammation and carotid atherosclerosis in patients with coronary artery disease. Am J Clin Nutr 86, 1392–8.

    CAS  PubMed  Google Scholar 

  82. Aldred, S., Sozzi, T., Mudway, I., Grant, M. M., Neubert, H., Kelly, F. J., and Griffiths, H. R. (2006) Alpha tocopherol supplementation elevates plasma apolipoprotein A1 isoforms in normal healthy subjects. Proteomics 6, 1695–703.

    CAS  PubMed  Google Scholar 

  83. Buijsse, B., Feskens, E. J., Schlettwein-Gsell, D., Ferry, M., Kok, F. J., Kromhout, D., and de Groot, L. C. (2005) Plasma carotene and alpha-tocopherol in relation to 10-y all-cause and cause-specific mortality in European elderly. Am J Clin Nutr 82, 879–86.

    CAS  PubMed  Google Scholar 

  84. Carpenter, K. L., Kirkpatrick, P. J., Weissberg, P. L., Challis, I. R., Dennis, I. F., Freeman, M. A., and Mitchinson, M. J. (2003) Oral alpha-tocopherol supplementation inhibits lipid oxidation in established human atherosclerotic lesions. Free Radic Res 37, 1235–44.

    CAS  PubMed  Google Scholar 

  85. Rapola, J. M., Virtamo, J., Haukka, J. K., Heinonen, O. P., Albanes, D., Taylor, P. R., and Huttunen, J. K. (1996) Effect of vitamin E and beta carotene on the incidence of angina pectoris: a randomized, double-blind, controlled trial. JAMA 275, 693–8.

    CAS  PubMed  Google Scholar 

  86. Gillilan, R. E., Mondell, B., and Warbasse, J. R. (1997) Quantitative evaluation of vitamin E in the treatment of angina pectoris. Am Heart J 93, 444–9.

    Google Scholar 

  87. Anderson, T. W., and Reid, D. B. (1974) A double-blind trial of vitamin E in angina pectoris. Am J Clin Nutr 27, 1174–8.

    CAS  PubMed  Google Scholar 

  88. Buijsse, B., Feskens, E. J., Kwape, L., Kok, F. J., and Kromhout, D. (2008) Both alpha- and beta-carotene, but not tocopherols and vitamin C, are inversely related to 15-year cardiovascular mortality in Dutch elderly men. J Nutr 138, 344–50.

    CAS  PubMed  Google Scholar 

  89. Morrison, H. I., Schaubel, D., Desmeules, M., and Wigle, D. T. (1996) Serum folate and risk of fatal coronary heart disease. JAMA 275, 1893–6.

    CAS  PubMed  Google Scholar 

  90. Giles, W. H., Kittner, S. J., Anda, R. F., Croft, J. B., and Casper, M. L. (1995) Serum folate and risk for ischemic stroke. Stroke 26, 1166–70.

    CAS  PubMed  Google Scholar 

  91. Voutilainen, S., Lakka, T. A., Porkkala-Sarataho, E., Rissanen, T., Kaplan, G. A., and Salonen, J. T. (2000) Low serum folate concentrations are associated with an excess incidence of acute coronary events. Eur J Clin Nutr 54, 424–8.

    CAS  PubMed  Google Scholar 

  92. Selhub, J., Jacques, P. F., Bostom, A. G., D’Agostino, R. B., Wilson, P. W., Belanger, A. J., O’Leary, D. H., Wolf, P. A., Schaefer, E. J., and Rosenberg, I. H. (1995) Association between plasma homocysteine concentrations and extracranial carotid-artery stenosis. N Engl J Med 332, 286–91.

    Google Scholar 

  93. Chasan-Taber, L., Selhub, J., Rosenberg, I. H., Malinow, M. R., Terry, P., Tishler, P. V., Willett, W., Hennekens, C. H., and Stampfer, M. J. (1996) A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians. J Am Coll Nutr 15, 136–43.

    CAS  PubMed  Google Scholar 

  94. Folsom, A. R., Nieto, F. J., McGovern, P. G., Tsai, M. Y., Malinow, M. R., Eckfeldt, J. H., Hess, D. L., and Davis, C. E. (1998) Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 98, 204–10.

    CAS  PubMed  Google Scholar 

  95. Wald, N. J., Watt, H. C., Law, M. R., Weir, D. G., McPartlin, J., and Scott, J. M. (1998) Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med 158, 862–7.

    CAS  PubMed  Google Scholar 

  96. Bots, M. L., Launer, L. J., Lindemans, J., Hofman, A., and Grobbee, D. E. (1997) Homocysteine, atherosclerosis and prevalent cardiovascular disease in the elderly. J Intern Med 242, 339–47.

    CAS  PubMed  Google Scholar 

  97. Perry, I. J., Refsum, H., Morris, R. W., Ebrahim, S. B., Ueland, P. M., and Shaper, A. G. (1995) Prospective study of serum total homocysteine concentration and risk of stroke in middle-aged British men. Lancet 346, 1395–8.

    CAS  PubMed  Google Scholar 

  98. Alfthan, G., Pekkanen, J., Jauhiainen, M., Pitkäniemi, J., Karvonen, M., Tuomilehto, J., Salonen, J. T., and Ehnholm, C. (1994) Relation of serum homocysteine and lipoprotein(a) concentrations to atherosclerotic disease in a prospective Finnish population based study. Atherosclerosis 106, 9–19.

    CAS  PubMed  Google Scholar 

  99. Robinson, K., Arheart, K., Refsum, H., Brattström, L., Boers, G., Ueland, P., Rubba, P., Palma-Reis, R., Meleady, R., Daly, L., Witteman, J., and Graham, I. (1998) Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation 97, 437–43.

    CAS  PubMed  Google Scholar 

  100. Boushey, C. J., Beresford, S. A., Omenn, G. S., and Motulsky, A. G. (1995) A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA 274, 1049–57.

    CAS  PubMed  Google Scholar 

  101. Jacques, P. F., Selhub, J., Bostom, A. G., Wilson, P. W., and Rosenberg, I. H. (1999) The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med 340, 1449–54.

    CAS  PubMed  Google Scholar 

  102. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330, 1029–35.

    Google Scholar 

  103. Rapola, J. M., Virtamo, J., Ripatti, S., Huttunen, J. K., Albanes, D., Taylor, P. R., and Heinonen, O. P. (1997) Randomised trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet 349, 1715–20.

    CAS  PubMed  Google Scholar 

  104. Virtamo, J., Rapola, J. M., Ripatti, S., Heinonen, O. P., Taylor, P. R., Albanes, D., and Huttunen, J. K. (1998) Effect of vitamin E and beta carotene on the incidence of primary nonfatal myocardial infarction and fatal coronary heart disease. Arch Intern Med 158, 668–75.

    CAS  PubMed  Google Scholar 

  105. Blot, W. J., Li, J. Y., Taylor, P. R., Juo, W., Dawsey, S., Wang, G. Q., Yang, C. S., Zheng, S. F., Gail, M., Li, G. Y., Yu, Y., Liu, B., Tangrea, J., Sun, Y., Liu, F., Fraumeni, J. F., Zhang, Y., and Li, B. (1993) Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 85, 1483–92.

    CAS  PubMed  Google Scholar 

  106. Wilson, T. S., Datta, S. B., Murrell, J. S., and Andrews, C. T. (1973) Relation of vitamin C levels to mortality in a geriatric hospital: a study of the effect of vitamin C administration. Age Ageing 2, 163–71.

    CAS  PubMed  Google Scholar 

  107. Omenn, G. S., Goodman, G. E., Thornquist, M. D., Balmes, J., Cullen, M. R., Glass, A., Keogh, J. P., Meyskens, F. L., Valanis, B., Williams, J. H., Barnhart, S., and Hammar, S. (1996) Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 334, 1150–5.

    CAS  PubMed  Google Scholar 

  108. Greenberg, E. R., Baron, J. A., Karagas, M. R., Stukel, T. A., Nierenberg, D. W., Stevens, M. M., Mandel, J. S., and Haile, R. W. (1996) Mortality associated with low plasma concentration of beta carotene and the effect of oral supplementation. JAMA 275, 699–703.

    CAS  PubMed  Google Scholar 

  109. Hennekens, C. H., Buring, J. E., Manson, J. E., Stampfer, M., Rosner, B., Cook, N. R., Belanger, C., LaMotte, F., Gaziano, J. M., Ridker, P. M., Willett, W., and Peto, R. (1996) Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 223, 1145–9.

    Google Scholar 

  110. Lee, I. M., Cook, N. R., Manson, J. E., Buring, J. E., and Hennekens, C. H. (1999) Beta-carotene supplementation and incidence of cancer and cardiovascular disease. J Natl Cancer Inst 91, 2102–6.

    CAS  PubMed  Google Scholar 

  111. Green, A., Williams, G., Neale, R., Hart, V., Leslie, D., Parsons, P., Marks, G. C., Gaffney, P., Battistutta, D., Frost, C., Lang, C., and Russell, A. (1999) Daily sunscreen application and beta-carotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 354, 723–9.

    CAS  PubMed  Google Scholar 

  112. Stephens, N. G., Parsons, A., Schofield, P. M., Kelly, F., Cheeseman, K., and Mitchinson, M. J. (1996) Randomised controlled trial of vitamin E in patients with coronary disease. Lancet 347, 781–6.

    CAS  PubMed  Google Scholar 

  113. GISSI-Prevenzione Investigators (Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico). (1999) Dietary supplementation with n–3 polyunsaturated fatty acids and vitamin E after myocardial infarction. Lancet 354, 447–55.

    Google Scholar 

  114. Yusuf, S., Dagenais, G., Pogue, J., Bosch, J., and Sleight, P. (2000) Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med 342, 154–60.

    CAS  PubMed  Google Scholar 

  115. Boaz, M., Smetana, S., Weinstein, T., Matas, Z., Gafter, U., Iaina, A., Knecht, A., Weissgarten, Y., Brunner, D., Fainaru, M., and Green, M. S. (2000) Secondary prevention with antioxidants of cardiovascular disease in endstage renal disease (SPACE): randomised placebo-controlled trial. Lancet 356, 1213–8.

    CAS  PubMed  Google Scholar 

  116. Heart Protection Study Collaborative Group. (2002) MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360, 23–33.

    Google Scholar 

  117. Lonn, E., Yusuf, S., Arnold, M. J., Sheridan, P., Pogue, J., Micks, M., McQueen, M. J., Probstfield, J., Fodor, G., Held, C., Genest, J. J., and Investigators. (2006) Homocysteine lowering with folic acid and B vitamins in vascular disease. Engl J Med 354, 1567–77.

    CAS  Google Scholar 

  118. Bostom, A. G., Selhub, J., Jacques, P. F., and Rosenberg, I. (2001) Power Shortage: clinical trials testing the “homocysteine hypothesis” against a background of folic acid-fortified cereal grain flour. Ann Intern Med 135, 133–7.

    CAS  PubMed  Google Scholar 

  119. Hankey, G. J., Eikelboom, J. W., Loh, K., Tang, M., Pizzi, J., Thom, J., and Yi, Q. (2005) Sustained homocysteine-lowering effect over time of folic acid-based multivitamin therapy in stroke patients despite increasing folate status in the population. Cerebrovasc Dis 19, 110–6.

    CAS  PubMed  Google Scholar 

  120. Bønaa, K. H., Njølstad, I., Ueland, P. M., Schirmer, H., Tverdal, A., Steigen, T., Wang, H., Nordrehaug, J. E., Arnesen, E., Rasmussen, K., and NORVIT Trial Investigators. (2006) Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med 354, 1578–88.

    PubMed  Google Scholar 

  121. Albert, C. M., Cook, N. R., Gaziano, J. M., Zaharris, E., MacFadyen, J., Danielson, E., Buring, J. E., and Manson, J. E. (2008) Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA 299, 2027–36.

    CAS  PubMed  Google Scholar 

  122. de Gaetano, G., and Collaborative Group of the Primary Prevention Project (PPP). (2001) Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Lancet 357, 89–95.

    PubMed  Google Scholar 

  123. Hercberg, S., Galan, P., Preziosi, P., Bertrais, S., Mennen, L., Malvy, D., Roussel, A. M., Favier, A., and Briançon, S. (2004) The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med 164, 2335–42.

    CAS  PubMed  Google Scholar 

  124. Brown, B. G., Zhao, X. Q., Chait, A., Fisher, L. D., Cheung, M. C., Morse, J. S., Dowdy, A. A., Marino, E. K., Bolson, E. L., Alaupovic, P., Frohlich, J., and Albers, J. J. (2001) Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 345, 1583–92.

    CAS  PubMed  Google Scholar 

  125. Waters, D. D., Alderman, E. L., Hsia, J., Howard, B. V., Cobb, F. R., Rogers, W. J., Ouyang, P., Thompson, P., Tardif, J. C., Higginson, L., Bittner, V., Steffes, M., Gordon, D. J., Proschan, D., Younes, N., and Verter, J. I. (2002) Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: a randomized controlled trial. JAMA 288, 2432–40.

    CAS  PubMed  Google Scholar 

  126. Salonen, J. T., Nyyssönen, K., Salonen, R., Lakka, H. M., Kaikkonen, J., Porkkala-Sarataho, E., Voutilainen, S., Lakka, T. A., Rissanen, T., Leskinen, L., Tuomainen, T. P., Valkonen, V. P., Ristonmaa, U., and Poulsen, H. E. (2000) Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study: a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis. J Intern Med 248, 377–86.

    CAS  PubMed  Google Scholar 

  127. Lonn, E., Yusuf, S., Dzavik, V., Doris, C., Yi, Q., Smith, S., Moore-Cox, A., Bosch, J., Riley, W., Teo, K., and Investigators. (2001) Effects of ramipril and vitamin E on atherosclerosis. Circulation 103, 919–25.

    CAS  PubMed  Google Scholar 

  128. Hodis, H. N., Mack, W. J., LaBree, L., Mahrer, P. R., Sevanian, A., Liu, C. R., Liu, C. H., Hwang, J., Selzer, R. H., Azen, S. P., and VEAPS Research Group. (2002) Alpha-tocopherol supplementation in healthy individuals reduces low-density lipoprotein oxidation but not atherosclerosis. Circulation 106, 1453–9.

    CAS  PubMed  Google Scholar 

  129. Steering Committee of the Physicians’ Health Study Research Group. (1989) Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med 321, 129–35.

    Google Scholar 

  130. Yusuf, S., Sleight, P., Pogue, J., Bosch, J., Davies, R., and Dagenais, G. (2000) Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 342,145–53.

    CAS  PubMed  Google Scholar 

  131. Heart Protection Study Collaborative Group. (2002) MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360, 7–22.

    Google Scholar 

  132. Toole, J. F., Malinow, M. R., Chambless, L. E., Spence, J. D., Pettigrew, L. C., Howard, V. J., Sides, E. G., Wang, C. H., and Stampfer, M. (2004) Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death. JAMA 291, 565–75.

    CAS  PubMed  Google Scholar 

  133. Ray, J. G., Kearon, C., Yi, Q., Sheridan, P., Lonn, E., and Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators. (2007) Homocysteine-lowering therapy and risk for venous thromboembolism: a randomized trial. Ann Intern Med 146, 761–7.

    PubMed  Google Scholar 

  134. Liem, A., Reynierse-Buitenwerf, G. H., Zwinderman, A. H., Jukema, J. W., and van Veldhuisen, D. J. (2003) Secondary prevention with folic acid: effects on clinical outcomes. J Am Coll Cardiol 41, 2105–13.

    CAS  PubMed  Google Scholar 

  135. Manson, J. E., Gaziano, J. M., Spelsberg, A., Ridker, P. M., Cook, N. R., Buring, J. E., Willett, W. C., and Hennekens, C. H. (1995) A secondary prevention trial of antioxidant vitamins and cardiovascular disease in women: rationale, design, and methods. Ann Epidemiol 5, 261–9.

    CAS  PubMed  Google Scholar 

  136. Schnyder, G., Roffi, M., Flammer, Y., Pin, R., and Hess, O. M. (2002) Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: a randomized controlled trial. JAMA 288, 973–9.

    CAS  PubMed  Google Scholar 

  137. Lange, H., Suryapranata, H., De Luca, G., Börner, C., Dille, J., Kallmayer, K., Pasalary, M. N., Scherer, E., and Dambrink, J. H. (2004) Folate therapy and in-stent restenosis after coronary stenting. N Engl J Med 350, 2673–81.

    CAS  PubMed  Google Scholar 

  138. Righetti, M., Serbelloni, P., Milani, S., and Ferrario, G. (2006) Homocysteine-lowering vitamin B treatment decreases cardiovascular events in hemodialysis patients. Blood Purif 24, 379–86.

    CAS  PubMed  Google Scholar 

  139. Righetti, M., Ferrario, G. M., Milani, S., Serbelloni, P., La Rosa, L., Uccellini, M., and Sessa, A. (2003) Effects of folic acid treatment on homocysteine levels and vascular disease in hemodialysis patients. Med Sci Monit 9, 19–24.

    Google Scholar 

  140. Zoungas, S., McGrath, B. P., Branley, P., Kerr, P. G., Muske, C., Wolfe, R., Atkins, R. C., Nicholls, K., Fraenkel, M., Hutchison, B. G., Walker, R., and McNeil, J. J. (2006) Cardiovascular morbidity and mortality in the Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) in chronic renal failure: a multicenter, randomized, controlled trial. J Am Coll Cardiol 47, 1108–16.

    CAS  PubMed  Google Scholar 

  141. Wrone, E. M., Hornberger, J. M., Zehnder, J. L., McCann, L. M., Coplon, N. S., and Fortmann, S. P. (2004) Randomized trial of folic acid for prevention of cardiovascular events in end-stage renal disease. J Am Soc Nephrol 15, 420–6.

    CAS  PubMed  Google Scholar 

  142. Pignoli, P., Tremoli, E., Poli, A., Oreste, P., and Paoletti, R. (1986) Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 74, 1399–406.

    CAS  PubMed  Google Scholar 

  143. Mack, W. J., LaBree, L., Liu, C., Selzer, R. H., and Hodis, H. N. (2000) Correlations between measures of atherosclerosis change using carotid ultrasonography and coronary angiography. Atherosclerosis 150, 371–9.

    CAS  PubMed  Google Scholar 

  144. Hodis, H. N., Mack, W. J., LaBree, L., Selzer, R. H., Liu, C. R., Liu, C. H., and Azen, S. P. (1998) The role of carotid arterial intima-media thickness in predicting clinical coronary events. Ann Intern Med 128, 262–9.

    CAS  PubMed  Google Scholar 

  145. Selzer, R. H., Hodis, H. N., Kwong-Fu, H., Mack, W. J., Lee, P. L., Liu, C. R., and Liu, C. H. (1994) Evaluation of computerized edge tracking for quantifying intima-media thickness of the common carotid artery from B-mode ultrasound images. Atherosclerosis 111, 1–11.

    CAS  PubMed  Google Scholar 

  146. Levy, A. P., Hochberg, I., Jablonski, K., Resnick, H. E., Lee, E. T., Best, L., Howard, B. V., and Strong Heart Study. (2002) Haptoglobin phenotype is an independent risk factor for cardiovascular disease in individuals with diabetes. J Am Coll Cardiol 40, 1984–90.

    PubMed  Google Scholar 

  147. Milman, U., Blum, S., Shapira, C., Aronson, D., Miller-Lotan, R., Anbinder, Y., Alshiek, J., Bennett, L., Kostenko, M., Landau, M., Keidar, S., Levy, Y., Khemlin, A., Radan, A., and Levy, A. P. (2008) Vitamin E supplementation reduces cardiovascular events in a subgroup of middle-aged individuals with both type 2 diabetes mellitus and the haptoglobin 2-2 genotype: a prospective double-blinded clinical trial. Arterioscler Thromb Vasc Biol 28, 341–7.

    CAS  PubMed  Google Scholar 

  148. Levy, A. P., Gerstein, H. C., Miller-Lotan, R., Ratner, R., McQueen, M., Lonn, E., and Pogue, J. (2004) The effect of vitamin E supplementation on cardiovascular risk in diabetic individuals with different haptoglobin phenotypes. Diabetes Care 27, 2767.

    PubMed  Google Scholar 

  149. Rimm, E. B., Willett, W. C., Hu, F. B., Sampson, L., Colditz, G. A., Manson, J. E., Hennekens, C., and Stampfer, M. J. (1998) Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 279, 359–64.

    CAS  PubMed  Google Scholar 

  150. Salonen, R. M., Nyyssönen, K., Kaikkonen, J., Porkkala-Sarataho, E., Voutilainen, S., Rissanen, T. H., Tuomainen, T. P., Valkonen, V. P., Ristonmaa, U., Lakka, H. M., Vanharanta, M., Salonen, J. T., and Poulsen, H. E. (2003) Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression. Circulation 107, 947–53.

    CAS  PubMed  Google Scholar 

  151. Lonn, E., Bosch, J., Yusuf, S., Sheridan, P., Pogue, J., Arnold, J. M., Ross, C., Arnold, A., Sleight, P., Probstfield, J., and Dagenais, G. R. (2005) Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 293, 1338–47.

    PubMed  Google Scholar 

  152. Blankenhorn, D. H., and Hodis, H. N. (1994) Arterial imaging and atherosclerosis reversal. Arterioscler Thromb 14, 177–92.

    CAS  PubMed  Google Scholar 

  153. Galan, P., de Bree, A., Mennen, L., Potier de Courcy, G., Preziozi, P., Bertrais, S., Castetbon, K., and Hercberg, S. (2003) Background and rationale of the SU.FOL.OM3 study: double-blind randomized placebo-controlled secondary prevention trial to test the impact of supplementation with folate, vitamin B6 and B12 and/or omega-3 fatty acids on the prevention of recurrent ischemic events in subjects with atherosclerosis in the coronary or cerebral arteries. J Nutr Health Aging 7, 428–35.

    CAS  PubMed  Google Scholar 

  154. Bostom, A. G., Carpenter, M. A., Kusek, J. W., Hunsicker, L. G., Pfeffer, M. A., Levey, A. S., Jacques, P. F., McKenney, J., and FAVORIT Investigators. (2006) Rationale and design of the Folic Acid for Vascular Outcome Reduction In Transplantation (FAVORIT) trial. Am Heart J 152, 448.e1–7.

    PubMed  Google Scholar 

  155. The VITATOPS Trial Study Group. (2002) The VITATOPS (Vitamins to Prevent Stroke) trial: rationale and design of an international, large, simple, randomised trial of homocysteine-lowering multivitamin therapy in patients with recent transient ischaemic attack or stroke. Cerebrovasc Dis 13, 120–6.

    Google Scholar 

  156. Bleie, Ø., Refsum, H., Ueland, P. M., Vollset, S. E., Guttormsen, A. B., Nexo, E., Schneede, J., Nordrehaug, J. E., and Nygård, O. (2004) Changes in basal and postmethionine load concentrations of total homocysteine and cystathionine after B vitamin intervention. Am J Clin Nutr 80, 641–8.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Juliana Hwang-Levine PHARM.D .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Hwang-Levine, J., Mack, W.J., Hodis, H.N. (2010). Antioxidant and B-vitamins and Atherosclerosis. In: Bendich, A., Deckelbaum, R. (eds) Preventive Nutrition. Nutrition and Health. Humana Press. https://doi.org/10.1007/978-1-60327-542-2_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-60327-542-2_12

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-541-5

  • Online ISBN: 978-1-60327-542-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics