Vitamin E and lipid peroxide plasma levels predict the risk of cardiovascular events in a group of healthy very old people

OBJECTIVES: To assess whether systemic oxidative stress can predict the ris k of first myocardial infarction, ischemic stroke, and congestive heart fai lure. DESIGN: A longitudinal study started in 1992 and completed in 1997. SETTING: Community-based, outpatient. PARTICIPANTS: 102 apparently healthy, community-dwelling subjects age 80 an d older from the Vibrata valley, Teramo, Italy. MEASUREMENTS: Plasma vitamin E, beta -carotene, vitamin C, fluorescent prod ucts of lipid peroxidation (FPLPs), and serum lipids were determined at enr ollment. RESULTS: Thirty-two cardiovascular events were recorded in 47.4 months of f ollow-up. The subjects with vitamin E levels in the highest quartile had a risk of cardiovascular events one-sixth those with vitamin E levels in the lowest quartile (relative risk (RR) = 0.16; 95% confidence interval (CI) = 0.04-0.55). The subjects with FPLPs in the highest quartile had a risk seve n times greater than those with FPLPs in the lowest quartile (RR = 7.61; 95 % CI = 2.23-25.96). No association, was observed for vitamin C, p-carotene, or total cholesterol. Multivariate adjustment for known risk factors did n ot significantly change the results. CONCLUSIONS: Our results suggest that in apparently healthy, cornmunity-dwe lling very old subjects, base-line plasma concentration of vitamin E and FP LPs predicts the risk of future cardiovascular events. We confirm previous data showing that total cholesterol is not a predictor of cardiovascular di sease in people age 80 and older.