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. 1995 Jun 17;310(6994):1563–1566. doi: 10.1136/bmj.310.6994.1563

Vitamin C and risk of death from stroke and coronary heart disease in cohort of elderly people.

C R Gale 1, C N Martyn 1, P D Winter 1, C Cooper 1
PMCID: PMC2549941  PMID: 7787644

Abstract

OBJECTIVES--To determine whether vitamin C status, as measured by dietary intake and plasma ascorbic acid concentration, is related to mortality from stroke and coronary heart disease in people aged 65 and over. DESIGN--A 20 year follow up study of a cohort of randomly selected elderly people living in the community who had taken part in the 1973-4 Department of Health and Social Security nutritional survey and for whom dietary and other data had been recorded. SETTING--Eight areas in Britain (five in England, two in Scotland, and one in Wales). SUBJECTS--730 men and women who had completed a seven day dietary record and who had no history or symptoms of stroke, cerebral arteriosclerosis, or coronary heart disease when examined by a geriatrician in 1973-4. RESULTS--Mortality from stroke was highest in those with the lowest vitamin C status. Those in the highest third of the distribution of vitamin C intake had a relative risk of 0.5 (95% confidence interval 0.3 to 0.8) compared with those in the lowest third, after adjustment for age, sex, and established cardiovascular risk factors. The relation between vitamin C intake and stroke was independent of social class and other dietary variables. A similar gradient in risk was present for plasma ascorbic acid concentrations. No association was found between vitamin C status and risk of death from coronary heart disease. CONCLUSION--In elderly people vitamin C concentration, whether measured by dietary intake or plasma concentration of ascorbic acid, is strongly related to subsequent risk of death from stroke but not from coronary heart disease.

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Selected References

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  1. Acheson R. M., Williams D. R. Does consumption of fruit and vegetables protect against stroke? Lancet. 1983 May 28;1(8335):1191–1193. doi: 10.1016/s0140-6736(83)92467-4. [DOI] [PubMed] [Google Scholar]
  2. Anderson K. M., Castelli W. P., Levy D. Cholesterol and mortality. 30 years of follow-up from the Framingham study. JAMA. 1987 Apr 24;257(16):2176–2180. doi: 10.1001/jama.257.16.2176. [DOI] [PubMed] [Google Scholar]
  3. Armstrong B. K., Mann J. I., Adelstein A. M., Eskin F. Commodity consumption and ischemic heart disease mortality, with special reference to dietary practices. J Chronic Dis. 1975 Oct;28(9):455–469. doi: 10.1016/0021-9681(75)90056-9. [DOI] [PubMed] [Google Scholar]
  4. Bonita R., Beaglehole R. Explaining stroke mortality trends. Lancet. 1993 Jun 12;341(8859):1510–1511. doi: 10.1016/0140-6736(93)90640-3. [DOI] [PubMed] [Google Scholar]
  5. Enstrom J. E., Kanim L. E., Klein M. A. Vitamin C intake and mortality among a sample of the United States population. Epidemiology. 1992 May;3(3):194–202. doi: 10.1097/00001648-199205000-00003. [DOI] [PubMed] [Google Scholar]
  6. Gey K. F., Stähelin H. B., Eichholzer M. Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke: Basel Prospective Study. Clin Investig. 1993 Jan;71(1):3–6. doi: 10.1007/BF00210955. [DOI] [PubMed] [Google Scholar]
  7. Jajich C. L., Ostfeld A. M., Freeman D. H., Jr Smoking and coronary heart disease mortality in the elderly. JAMA. 1984 Nov 23;252(20):2831–2834. [PubMed] [Google Scholar]
  8. Khaw K. T., Barrett-Connor E., Suarez L., Criqui M. H. Predictors of stroke-associated mortality in the elderly. Stroke. 1984 Mar-Apr;15(2):244–248. doi: 10.1161/01.str.15.2.244. [DOI] [PubMed] [Google Scholar]
  9. Knekt P., Reunanen A., Järvinen R., Seppänen R., Heliövaara M., Aromaa A. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994 Jun 15;139(12):1180–1189. doi: 10.1093/oxfordjournals.aje.a116964. [DOI] [PubMed] [Google Scholar]
  10. Rimm E. B., Stampfer M. J., Ascherio A., Giovannucci E., Colditz G. A., Willett W. C. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med. 1993 May 20;328(20):1450–1456. doi: 10.1056/NEJM199305203282004. [DOI] [PubMed] [Google Scholar]
  11. Rose G., Shipley M. J. Plasma lipids and mortality: a source of error. Lancet. 1980 Mar 8;1(8167):523–526. doi: 10.1016/s0140-6736(80)92775-0. [DOI] [PubMed] [Google Scholar]
  12. Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature. 1993 Apr 29;362(6423):801–809. doi: 10.1038/362801a0. [DOI] [PubMed] [Google Scholar]
  13. Shipley M. J., Pocock S. J., Marmot M. G. Does plasma cholesterol concentration predict mortality from coronary heart disease in elderly people? 18 year follow up in Whitehall study. BMJ. 1991 Jul 13;303(6794):89–92. doi: 10.1136/bmj.303.6794.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Smith G. D., Shipley M. J., Marmot M. G., Rose G. Plasma cholesterol concentration and mortality. The Whitehall Study. JAMA. 1992 Jan 1;267(1):70–76. [PubMed] [Google Scholar]
  15. Stringer M. D., Görög P. G., Freeman A., Kakkar V. V. Lipid peroxides and atherosclerosis. BMJ. 1989 Feb 4;298(6669):281–284. doi: 10.1136/bmj.298.6669.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Verlangieri A. J., Kapeghian J. C., el-Dean S., Bush M. Fruit and vegetable consumption and cardiovascular mortality. Med Hypotheses. 1985 Jan;16(1):7–15. doi: 10.1016/0306-9877(85)90035-0. [DOI] [PubMed] [Google Scholar]
  17. Welin L., Svärdsudd K., Wilhelmsen L., Larsson B., Tibblin G. Analysis of risk factors for stroke in a cohort of men born in 1913. N Engl J Med. 1987 Aug 27;317(9):521–526. doi: 10.1056/NEJM198708273170901. [DOI] [PubMed] [Google Scholar]
  18. Winawer S. J., Flehinger B. J., Buchalter J., Herbert E., Shike M. Declining serum cholesterol levels prior to diagnosis of colon cancer. A time-trend, case-control study. JAMA. 1990 Apr 18;263(15):2083–2085. [PubMed] [Google Scholar]
  19. Witztum J. L. The oxidation hypothesis of atherosclerosis. Lancet. 1994 Sep 17;344(8925):793–795. doi: 10.1016/s0140-6736(94)92346-9. [DOI] [PubMed] [Google Scholar]

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