Antioxidant vitamins and the risk of carotid atherosclerosis - The Perth Carotid Ultrasound Disease Assessment Study (CUDAS)

Objectives This study, examined whether dietary intake or plasma levels of antioxidant vitamins were independently associated with common carotid arte ry intima-media (wall) thickness (IMT) or focal plaque, or both, in a large , randomly selected community population. Background Oxidation of low-density lipoprotein (LDL) cholesterol is though t to be important in early atherogenesis. Antioxidant micronutrients may th erefore protect against lipid peroxidation and atherosclerotic vascular dis ease. Methods We studied 1,111 subjects (558 men and 553 women; age 52 +/- 13 yea rs [mean +/- SD], range 27 to 77). We measured dietary vitamin intake and f asting plasma levels of vitamins A, C and E, lycopene and alpha- and beta-c arotene and performed bilateral carotid artery B-mode ultrasound imaging. Results After adjustment for age and conventional risk factors, there was a progressive decrease in mean IMT, with increasing quartiles of dietary vit amin E intake in men (p=0.02) and a nonsignificant trend in women (p=0.10). Dietary vitamin E levels accounted for 1% of the variance in measured IMT in men. For plasma antioxidant vitamins, there was an inverse association b etween carotid artery mean IMT and plasma lycopene in women (p=0.047), but not in men. None of the other dietary or plasma antioxidant vitamins, nor a ntioxidant vitamin supplements, were associated with carotid artery IMT or focal carotid artery plaque. Conclusions This study provides limited support for the hypothesis that inc reased dietary intake of vitamin E and increased plasma lycopene may decrea se the risk of atherosclerosis. No benefit was demonstrated for supplementa l antioxidant vitamin use. (J Am Coll Cardiol 2001;38: 1798-94) (C) 2001 by the American College of Cardiology.