High vitamin E plasma levels and low low-density lipoprotein oxidation areassociated with the absence of atherosclerosis in octogenarians

OBJECTIVES: To identify the biological characteristics of older subjects wi th vascular successful aging (VASA), defined as the absence of instrumental signs and clinical symptoms of atherosclerosis in the extracoronary and co ronary vessels. DESIGN: A cross-sectional study. SETTING: A university-affiliated outpatient clinic. PARTICIPANTS: Sixty older subjects (30 with VASA and 30 controls with moder ate carotid atherosclerosis (AG group)) from a sample of 705 subjects age 7 5 and older consecutively screened. MEASUREMENTS: Clinical examination; ultrasonographic examination of carotid , vertebral, abdominal aortic, iliac, and femoral arteries; electrocardiogr am; and laboratory evaluation (lipid profile, lipophilic antioxidants, and markers of low-density lipoprotein (LDL) oxidation). RESULTS: Compared with controls, there were more females in the VASA group (82% vs 50%, P < .01), and fewer previous smokers (20.5% vs 52.5%, P < .01) . Vitamin E/total cholesterol levels both in plasma (4.81 vs 3.51 mu mol/mm ol, P < .001) and in isolated LDLs (2.71 vs 1.86 mug/mg LDL cholesterol (LD L-C), P < .01), were higher in the VASA group, as was the resistance of LDL s to in vitro oxidation las indicated by a longer duration of the lag phase : 80.2 vs 65.6 minutes, P < .001). The level of fluorescent products of lip id peroxidation (FPLPs) in native LDLs was lower in the VASA group (13.5 vs 18.8 URF/mg LDL-C, P < .001). Multivariate logistic regression analysis sh owed that only plasma vitamin E level (odds ratio (OR) = 6.04, 95% confiden ce interval (CI) = 1.48-24.43) and FPLPs in LDLs (OR = 0.53, 95% CI = 0.31- 0.91) were independently associated with VASA. CONCLUSIONS: These results suggest that an appropriate level of vitamin E a nd a low level of LDL oxidation might be important for reaching advanced ag e without developing atherosclerosis.