Intake of flavonols and flavones and risk of coronary heart disease in male smokers

Flavonols and flavones are antioxidant polyphenolic compounds found in tea, vegetables, fruits, and wine. In experimental studies they have been effec tive free radical scavengers, metal chelators, and antithrombotic agents. I n the few epidemiologic studies of these agents, some have suggested an inv erse association between intake of flavonols and flavones and the risk of c ardiovascular disease. Our study population comprised 25,372 male smokers, 50-69 years of age, with no previous myocardial infarction. They were parti cipants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, whi ch was a randomized, double-blind, placebo-controlled trial with daily supp lementation of alpha-tocopherol (50 mg per day) and/or beta-carotene (20 mg per day). The men completed a validated dietary questionnaire at baseline. After 6.1 years of follow-up, there were 1,122 nonfatal myocardial infarct ions and 815 coronary deaths. In the multivariate model, the relative risk of nonfatal myocardial infarction was 0.77 (95% confidence interval = 0.64- 0.93) among men in the highest (median 18 mg per day) compared with the low est (median 4 mg per day) quintile of flavonol and flavone intake. The resp ective relative risk for coronary death was 0.89 (95% confidence interval = 0.71-1.11). Thus, intake of flavonols and flavones was inversely associate d with nonfatal myocardial infarction, whereas there was a weaker associati on with coronary death.