Oral vitamin C and endothelial function in smokers: Short-term improvement, but no sustained beneficial effect

OBJECTIVE To test the hypothesis that antioxidant therapy would improve end othelial function in smokers. BACKGROUND Several studies have documented a beneficial effect of short-ter m oral or parenteral vitamin C on endothelial physiology in subjects with e arly arterial dysfunction. Possible long-term effects of vitamin C on endot helial function, however, are not known. METHODS We studied the effects of short- and long-term oral vitamin C thera py 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 I g vitamin C daily, and after placebo, in a randomized double-blind cross over study. Blood samples were analyzed for plasma ascorbate levels and end othelial function was measured as flow-mediated dilation of the brachial ar tery, using high resolution ultrasound. Nitroglycerin-mediated dilation (en dothelium-independent) was also measured at each visit. RESULTS At baseline, plasma ascorbate level nas low in the smokers (42 +/- 21 mu mol/liter; normal range, 50 to 150 mu mol/liter), increased with vita min C therapy after 2 h to 120 +/- 54 mu mol/liter (p < 0.001) and remained elevated after eight weeks of supplementation at 92 +/- 32 mu mol/liter (p < 0.001, compared with placebo). Flow-mediated dilation, however, increase d at 2 h (from 2.8 +/- 2.0% to 6.3 +/- 2.8%, p < 0.001), but there was no s ustained beneficial effect after eight weeks (3.9 +/- 3.2%, p = 0.26). Nitr oglycerin-mediated dilation was unchanged throughout. CONCLUSION Oral vitamin C therapy improves endothelial dysfunction in the s hort term in healthy young smokers, but it has no beneficial long-term effe ct, despite sustained elevation of plasma ascorbate levels. (C) 2000 by the American College of Cardiology.