ascorbic-acid and Angina-Pectoris

For the prolongation of life expectancy and reduction of ischemic heart disease (IHD) dietary guidelines generally recommend lowering saturated mammalian fat with partial replacement by vegetable oils and increasing generously vegetables, legumes, and fruits, which provide more essential antioxidants. Plasma antioxidants as assayed in epidemiological studies of complementary type (ie the cross-cultural MONICA Vitamin Substudy reevaluation considering the "Finland-Factor", the Edinburgh Angina-Control Study, and the Basel Prospective Study) consistently revealed an increased risk of IHD (and stroke) at low plasma concentrations of antioxidants, with the rank order as follows: lipid-standardized vitamin E >> carotene = vitamin C > vitamin A, independently of classical IHD risk factors. Decreasing IHD risk through nutrition may be possible when plasma concentrations have the following values: > 27.5-30.0 mumol vitamin E/L, 0.4-0.5 mumol carotene/L, 40-50 mumol vitamin C/L and 2.2-2.8 mumol vitamin A/L. Thus, previous prudent regimens may now be updated, aiming at an optimal status of all essential and synergistically linked antioxidants.

Topics: Angina Pectoris; Ascorbic Acid; Blood Pressure; Carotenoids; Cerebrovascular Disorders; Cholesterol; Cross-Cultural Comparison; Humans; Male; Middle Aged; Myocardial Ischemia; Risk Factors; Selenium; Vitamin E

The aim of this study was to evaluate the effect of high-dose allopurinol on vascular oxidative stress (OS) and endothelial function in subjects with stable coronary artery disease (CAD).. Allopurinol, a xanthine oxidase inhibitor, prolongs the time to chest pain during exercise in angina. We sought to ascertain whether allopurinol also improves endothelial dysfunction in optimally treated CAD patients, because such an effect might be of value to reduce future cardiovascular mortality. The mechanism of the anti-ischemic effect of allopurinol could be related to its reducing xanthine oxidase-induced OS, and our second aim was to see whether allopurinol really does reduce vascular tissue OS in CAD patients.. A randomized, double-blind, placebo-controlled, crossover study was conducted in 80 patients with CAD, comparing allopurinol (600 mg/day) with placebo. Endothelial function was assessed by forearm venous occlusion plethysmography, flow-mediated dilation, and pulse wave analysis. Vascular OS was assessed by intra-arterial co-infusion of vitamin C and acetylcholine.. Compared with placebo, allopurinol significantly improved endothelium-dependent vasodilation, by both forearm venous occlusion plethysmography (93 ± 67% vs. 145 ± 106%, p = 0.006) and flow-mediated dilation (4.2 ± 1.8% vs. 5.4 ± 1.7%, p < 0.001). Vascular oxidative stress was completely abolished by allopurinol. Central augmentation index improved significantly with allopurinol (2.6 ± 7.0%, p < 0.001) but not with placebo.. Our study demonstrates that, in optimally treated CAD patients, high-dose allopurinol profoundly reduces vascular tissue OS and improves 3 different measures of vascular/endothelial dysfunction. The former effect on OS might underpin the anti-ischemic effect of allopurinol in CAD. Both effects (on OS and endothelial dysfunction) increase the likelihood that high-dose allopurinol might reduce future cardiovascular mortality in CAD, over and above existing optimum therapy. (Exploring the therapeutic potential of xanthine oxidase inhibitor allopurinol in angina; ISRCTN15253766).

Topics: Aged; Allopurinol; Angina Pectoris; Antioxidants; Ascorbic Acid; Blood Flow Velocity; Brachial Artery; Coronary Artery Disease; Cross-Over Studies; Dose-Response Relationship, Drug; Double-Blind Method; Endothelium, Vascular; Enzyme Inhibitors; F2-Isoprostanes; Female; Humans; Lipoproteins, LDL; Male; Natriuretic Peptide, Brain; Oxidative Stress; Plethysmography; Regional Blood Flow; Ultrasonography

Our goal was to explore whether antioxidant vitamin C infusion is able to affect the microcirculation perfusion in patients undergoing elective percutaneous coronary intervention for stable angina.. Periprocedural myocardial injury in the setting of elective percutaneous coronary intervention is associated with increased risk of death, recurrent infarction, and revascularization at follow-up. Despite excellent epicardial blood flow, impaired microcirculatory reperfusion may persist and increases the risk of vascular recurrences. Post-percutaneous coronary intervention induced-oxidative stress is one of the potential mechanisms accounting for impaired perfusion.. Fifty-six patients were enrolled in a prospective, single-center, randomized study comparing 1 g vitamin C infusion (16.6 mg/min, over 1 h before percutaneous coronary intervention) versus placebo.. At the baseline, Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade <2 was observed in 89% and in 86% of patients randomized to the placebo or vitamin C infusion group, respectively (p > 0.05). After percutaneous coronary intervention, these percentages decreased in the placebo group (32%) and in greater measure in the vitamin C group (4%, p < 0.01). Complete microcirculatory reperfusion (TIMI myocardial perfusion grade = 3) was achieved in 79% of the vitamin C-treated group compared with 39% of the placebo group (p < 0.01); 8-hydroxy-2-deoxyguanosine (p < 0.002) and 8-iso-prostaglandin F(2alpha) (p < 0.02) plasma levels significantly increased in the placebo group while they were significantly reduced in the vitamin C-treated group (p < 0.0001). TIMI myocardial perfusion grade changes from the baseline showed significant correlation with 8-hydroxy-2-deoxyguanosine (p < 0.006) or 8-iso-prostaglandin F(2alpha) (p < 0.01) plasma levels changes.. In patients undergoing elective percutaneous coronary intervention, impaired microcirculatory reperfusion is improved by vitamin C infusion suggesting that oxidative stress is implicated in such a phenomenon.

Topics: Aged; Aged, 80 and over; Angina Pectoris; Angioplasty, Balloon, Coronary; Antioxidants; Ascorbic Acid; Biomarkers; Elective Surgical Procedures; Female; Health Status Indicators; Humans; Inflammation; Male; Microcirculation; Middle Aged; Multivariate Analysis; Myocardial Reperfusion; Oxidative Stress; Statistics as Topic; Stroke Volume; Ventricular Function, Left

Lipid lowering with statins prevents adverse cardiac events. Both lipid-lowering and antioxidant therapies may favorably affect vasomotor function and thereby improve ischemia.. In a randomized, double-blind, placebo-controlled trial, 300 patients with stable coronary disease, a positive exercise treadmill test, 48-hour ambulatory ECG with > or =1 episode of ischemia, and fasting total cholesterol of 180 to 250 mg/dL were assigned to 1-year treatment with intensive atorvastatin to reduce LDL to <80 mg/dL (n=96), intensive atorvastatin to reduce LDL to <80 mg/dL plus antioxidant vitamins C (1000 mg/d) and E (800 mg/d) (n=101), or diet and low-dose lovastatin, if needed, to reduce LDL to <130 mg/dL (n=103; control group). Ischemia end points, including ambulatory ECG monitoring and exercise treadmill testing, and endothelial assessment using brachial artery flow-mediated dilation were obtained at baseline and at 6 and 12 months. Baseline characteristics were similar in all groups. LDL decreased from approximately 153 mg/dL at baseline in the 2 atorvastatin groups to approximately 83 mg/dL at 12 months (each P<0.0001) and from 147 to 120 mg/dL in the control group (P<0.0001). During ambulatory ECG monitoring, mean number of ischemic episodes per 48 hours decreased 31% to 61% in each group (each P<0.001; P=0.15 across groups), without a change in daily heart rate activity. Mean duration of ischemia for 48 hours decreased 26% to 62% in each group (each P<0.001; P=0.06 across groups). Mean exercise duration to 1-mm ST-segment depression significantly increased in each group, but total exercise duration and mean sum of maximum ST depression were unchanged. Angina frequency decreased in each group. There was no incremental effect of supplemental vitamins C and E on any ischemia outcome. Flow-mediated dilation studies indicated no meaningful changes.. Intensive lipid lowering with atorvastatin to an LDL level of 80 mg/dL, with or without antioxidant vitamins, does not provide any further benefits in ambulatory ischemia, exercise time to onset of ischemia, and angina frequency than moderate lipid lowering with diet and low-dose lovastatin to an LDL level of <120 mg/dL.

Topics: Angina Pectoris; Antioxidants; Ascorbic Acid; Atorvastatin; Coronary Artery Disease; Diet Therapy; Dose-Response Relationship, Drug; Exercise Test; Female; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Lipid Metabolism; Lipids; Lipoproteins, LDL; Male; Myocardial Ischemia; Pyrroles; Vasomotor System; Vitamin E

To assess the effects of intravenous vitamin C administration on the vasomotor responses to intracoronary L-arginine infusion in epicardial coronary arteries.. 28 patients with coronary artery disease and stable angina were enrolled in the study. Eight patients received intracoronary infusions of 150 micromol/min L-arginine before and after intravenous infusion of vitamin C, 10 patients received intracoronary infusions of 150 micromol/min L-arginine before and after intravenous infusion of normal saline, and 10 patients received intracoronary normal saline before and after intravenous infusion of vitamin C. The diameter of proximal and distal coronary artery segments was measured by quantitative angiography.. Infusion of L-arginine caused significant dilatation of both proximal (4.87 (0.96)%, p < 0.01 v normal saline) and distal (6.33 (1.38)%, p < 0.01 v normal saline) coronary segments. Co-infusion of vitamin C and L-arginine dilated proximal coronary segments by 8.68 (1.40)% (p < 0.01 v normal saline, p < 0.01 v L-arginine) and distal segments by 13.07 (2.15)% (p < 0.01 v normal saline, p < 0.01 v L-arginine). Intravenous infusion of vitamin C caused a borderline increase in proximal and distal coronary segment diameters (1.93 (0.76)% and 2.09 (1.28)%, respectively, not significant).. L-arginine dependent coronary segment vasodilatation was augmented by the antioxidant vitamin C in patients with coronary artery disease. Thus, vitamin C may have beneficial effects on nitric oxide bioavailability induced by L-arginine.

Topics: Angina Pectoris; Antioxidants; Arginine; Ascorbic Acid; Coronary Angiography; Coronary Artery Disease; Coronary Vessels; Drug Combinations; Drug Interactions; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Nitric Oxide; Vasodilation

The relation between risk of angina pectoris and plasma concentrations of vitamins A, C, and E and carotene was examined in a population case-control study of 110 cases of angina, identified by the Chest Pain Questionnaire, and 394 controls selected from a sample of 6000 men aged 35-54. Plasma concentrations of vitamins C and E and carotene were significantly inversely related to the risk of angina. There was no significant relation with vitamin A. Smoking was a confounding factor. The inverse relation between angina and low plasma carotene disappeared and that with plasma vitamin C was substantially reduced after adjustment for smoking. Vitamin E remained independently and inversely related to the risk of angina after adjustment for age, smoking habit, blood pressure, lipids, and relative weight. The adjusted odds ratio for angina between the lowest and highest quintiles of vitamin E concentrations was 2.68 (95% confidence interval 1.07-6.70; p = 0.02). These findings suggest that some populations with a high incidence of coronary heart disease may benefit from eating diets rich in natural antioxidants, particularly vitamin E.

Topics: Adult; Angina Pectoris; Ascorbic Acid; Carotenoids; Case-Control Studies; Confounding Factors, Epidemiologic; Humans; Lipids; Male; Middle Aged; Odds Ratio; Risk Factors; Seasons; Smoking; Surveys and Questionnaires; Vitamin A; Vitamin E

Topics: Angina Pectoris; Angioplasty, Balloon, Coronary; Antioxidants; Ascorbic Acid; Humans; Myocardial Reperfusion; Oxidative Stress

Electrochemical determination of amlodipine besylate (ADB) using single and multi-walled carbon nanotubes modified edge plane pyrolytic graphite electrodes (SWNT/EPPGE and MWNT/EPPGE) is described by using cyclic and square wave voltammetries at physiological pH 7.2. An increased peak current with a shift of peak potential to less positive value was observed using carbon nanotubes modified EPPGE as compared to bare electrode. The effect of pH, scan rate and analyte concentration has been examined. Under the optimum conditions the peak current was linear to the concentration of amlodipine in the range 5.0 x 10(-9) to 1.0 x 10(-6) mol L(-1) for SWNT/EPPGE and the detection limit was found to be 1.0 x 10(-9) mol L(-1) whereas, for MWNT/EPPGE the detection limit was found to be 5.0 x 10(-9) mol L(-1). The method was successfully used to determine the content of amlodipine in the pharmaceutical preparations and human urine samples of angina patients undergoing treatment with amlodipine. A comparison of electrocatalytic activities of SWNT and MWNT modified electrodes indicated that SWNT modified EPPGE is approximately 1.8 times more sensitive in comparison to MWNT/EPPGE. Biological relevance of the developed method has been described by the determination of amlodipine in human body fluids. Amlodipine can be determined without any interference from common urine metabolites such as uric acid, ascorbic acid and xanthine.

Topics: Amlodipine; Angina Pectoris; Antihypertensive Agents; Ascorbic Acid; Body Fluids; Carbon; Electrodes; Humans; Hydrogen-Ion Concentration; Limit of Detection; Microscopy, Electron, Scanning; Nanotechnology; Nanotubes, Carbon; Pharmaceutical Preparations; Potentiometry; Reproducibility of Results; Uric Acid; Xanthine

The organic nitrate drugs, such as glyceryl trinitrate (GTN; nitroglycerin), are clinically effective in angina because of their dilator profile in veins and arteries. The exact mechanism of intracellular delivery of nitric oxide (NO), or another NO-containing species, from these compounds is not understood. However, mitochondrial aldehyde dehydrogenase (mtALDH) has recently been identified as an organic nitrate bioactivation enzyme. Nitrate tolerance, the loss of effect of organic nitrates over time, is caused by reduced bioactivation and/or generation of NO-scavenging oxygen-free radicals. In a recent issue of the British Journal of Pharmacology, Wenzl et al. show that guinea-pigs, deficient in ascorbate, also have impaired responsiveness to GTN, but nitrate tolerance was not due to ascorbate deficiency that exhibited divergent changes in mtALDH activity. Thus, the complex function of mtALDH appears to be the key to activation of GTN, the active NO species formed and the induction of tolerance that can limit clinical effectiveness of organic nitrate drugs.

Topics: Aldehyde Dehydrogenase; Angina Pectoris; Animals; Ascorbic Acid; Drug Tolerance; Mitochondria; Nitrates; Nitric Oxide; Nitroglycerin; Vasodilator Agents

To examine the relation between serum ascorbic acid concentration, which reflects dietary and supplement intake, and the prevalence of cardiovascular disease.. We analyzed data from 7658 men and women enrolled in the Third National Health and Nutrition Examination Survey (NHANES III). We calculated odds ratios and 95% confidence intervals (CI) to estimate the relative prevalence of cardiovascular disease, defined as self-reported angina, myocardial infarction, or stroke. Because we detected an interaction between serum ascorbic acid concentration and alcohol intake, we performed analyses stratified by drinking status.. Among participants who reported no alcohol consumption, serum ascorbic acid concentrations were not independently associated with cardiovascular disease prevalence. Among participants who consumed alcohol, serum ascorbic acid concentrations consistent with tissue saturation (1.0-3.0 mg/dl) were associated with a decreased prevalence of angina (multivariate odds ratio (OR): 0.48; 95% CI: 0.23% to 1.03; p for trend = 0.06), but were not significantly associated with myocardial infarction or stroke prevalence.. These results suggest the possibility of a biologic interaction between ascorbic acid and alcohol and that higher intakes of ascorbic acid may be associated with a decreased risk of angina among drinkers.

Topics: Adult; Aged; Aged, 80 and over; Alcohol Drinking; Angina Pectoris; Ascorbic Acid; Cardiovascular Diseases; Female; Health Surveys; Humans; Male; Middle Aged; Prevalence; United States

This study sought to investigate the relations between plasma antioxidant status, extent of atherosclerosis and activity of coronary artery disease.. Previous studies indicate that increased antioxidant intake is associated with decreased coronary disease risk, but the underlying mechanisms remain controversial.. Plasma samples were obtained from 149 patients undergoing cardiac catheterization (65 with stable angina, 84 with unstable angina or a myocardial infarction within 2 weeks). Twelve plasma antioxidant/oxidant markers were measured and correlated with the extent of atherosclerosis and the presence of an unstable coronary syndrome.. By multiple linear regression analysis, age (p < 0.001), diabetes mellitus (p < 0.001), male gender (p < 0.001) and hypercholesterolemia (p = 0.02) were independent predictors of the extent of atherosclerosis. No antioxidant/oxidant marker correlated with the extent of atherosclerosis. However, lower plasma ascorbic acid concentration predicted the presence of an unstable coronary syndrome by multiple logistic regression (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.40 to 0.89, p = 0.01). The severity of atherosclerosis also predicted the presence of an unstable coronary syndrome (OR 1.7, 95% CI 1.14 to 2.47, p = 0.008) when all patients were considered. When only patients with significant coronary disease were considered (at least one stenosis >50%), ascorbic acid concentration (OR 0.56, 95% CI 0.37 to 0.85, p = 0.008) and total plasma thiols (OR 0.52, 95% CI 0.34 to 0.80, p = 0.004) predicted the presence of an unstable coronary syndrome, whereas the extent of atherosclerosis did not.. These data are consistent with the hypothesis that the beneficial effects of antioxidants in coronary artery disease may result, in part, by an influence on lesion activity rather than a reduction in the overall extent of fixed disease.

Topics: Aged; Angina Pectoris; Angina, Unstable; Antioxidants; Arteriosclerosis; Ascorbic Acid; Biomarkers; Coronary Disease; Female; Humans; Linear Models; Lipid Peroxidation; Logistic Models; Male; Middle Aged; Myocardial Infarction

Impaired endothelium-dependent vasodilation has been reported to play an important role in the pathogenesis of cardiovascular diseases such as coronary artery disease (CAD) and congestive heart failure (CHF). However, the precise mechanism of endothelial dysfunction has not been elucidated in these conditions. To evaluate the role of oxidative stress in endothelial dysfunction, the effect of antioxidant ascorbic acid on brachial flow-mediated, endothelium-dependent vasodilation during reactive hyperemia and nitroglycerin-induced endothelium-independent vasodilation was examined with high resolution ultrasound in 12 patients with CHF caused by idiopathic dilated cardiomyopathy without established coronary atherosclerosis and in 10 patients with CAD. Flow-mediated vasodilation in CHF (4.4+/-0.5%) and CAD (4.0 - 0.8%) was significantly (p <0.05) attenuated compared with that in 10 control subjects (9.6+/-0.9%). However, nitroglycerin-induced vasodilation was similar in 3 groups (13.7+/-1.3% in control, 13.9+/-1.1% in CHF, 12.7+/-1.4% in CAD). Ascorbic acid could significantly improve flow-mediated vasodilation only in patients with CAD (9.1+/-0.9%) but not with CHF (5.6+/-0.6%), and had no influence on nitroglycerin-induced vasodilation (13.6+/-1.1% in CHF, 14.0+/-1.3% in CAD). These results suggest that, in brachial circulation, augmented oxidative stress mainly leads to endothelial dysfunction in CAD but not in CHF caused by idiopathic dilated cardiomyopathy.

Topics: Adult; Aged; Angina Pectoris; Ascorbic Acid; Blood Flow Velocity; Brachial Artery; Cardiomyopathy, Dilated; Coronary Disease; Endothelium, Vascular; Female; Follow-Up Studies; Heart Failure; Humans; Male; Middle Aged; Nitroglycerin; Reproducibility of Results; Ultrasonography, Doppler; Vasodilation; Vasodilator Agents

The authors' study show that intravenous He-Ne laser therapy (HNLT) in patients with stable angina of effort (functional class II-III) and postinfarction cardiosclerosis irrespective of ejection fraction increased plasma katalase and red cell vitamin A concentrations. HNLT aroused vitamin E concentration in red cells in anginal patients with intact ejection fraction whereas in those with reduced ejection fraction it elevated blood peroxidase, plasma vitamin A and E concentrations. For patients with postinfarction cardiosclerosis there were, respectively, higher levels of blood peroxidase, plasmic vitamin A, red cell vitamin E, plasmic SH-groups and blood peroxidase, plasmic vitamins A and E.

Topics: Adult; Angina Pectoris; Angioplasty, Balloon, Laser-Assisted; Ascorbic Acid; Catalase; Ceruloplasmin; Female; Helium; Humans; Isotopes; Male; Middle Aged; Myocardial Infarction; Myocardium; Neon; Physical Exertion; Sclerosis; Vitamin A; Vitamin E

Vitamin C has been suggested to be protective for coronary heart disease but the evidence from epidemiological studies is inconclusive and most studies have been conducted in men. We examined the cross-sectional relationship between vitamin C status and previously undiagnosed angina in women.. Women aged 45-74 years were recruited from general practices. They completed a health and lifestyle questionnaire and attended for a health check and a blood test. Non-fasting plasma vitamin C was used to define vitamin status and a self-completed Rose angina questionnaire was used to identify cases.. Forty-two women with previously undiagnosed angina (cases) were compared with 877 women with no reported angina (controls). The mean plasma vitamin C was 50.2 mumol/l in cases and 58.3 mumol/l in controls. The age-adjusted odds ratio for a 50 mumol/l increase in plasma vitamin C was 0.34 (95% confidence interval 0.15-0.79). The odds ratio was unaltered after adjustment for body mass index, smoking and established coronary risk factors, and after stratification by smoking, vitamin supplementation and hormone replacement.. This cross-sectional analysis showed an association in women between lower plasma levels of vitamin C and previously undiagnosed angina. Although we are unable to exclude the possibility that symptomatic prevalent disease modifies plasma vitamin C levels, these data are consistent with a protective effect of vitamin C for coronary heart disease. This relationship requires confirmation in further prospective studies and trials of vitamin C supplementation.

Topics: Aged; Angina Pectoris; Ascorbic Acid; Confidence Intervals; Coronary Disease; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Odds Ratio; Reference Values; Risk Factors; Sensitivity and Specificity; Surveys and Questionnaires

A 71-year-old woman was admitted with end-stage renal failure and histological evidence of oxalosis. This case of diffuse renal tubular crystal calcium oxalate deposits seems to be induced by long-term piridoxilate therapy (10 years) or simultaneous intake of both piridoxilate and vitamin C (500 mg/day for 6 months), since no other cause of secondary oxalosis could be found. So, it seems necessary to monitor the serum creatinine level, especially in the elderly, during piridoxilate therapy and to avoid high vitamin C intakes in patients under such treatment to prevent development of renal insufficiency.

Topics: Aged; Angina Pectoris; Ascorbic Acid; Calcium Oxalate; Creatinine; Drug Interactions; Female; Humans; Kidney Diseases; Kidney Failure, Chronic; Kidney Tubules; Pyridoxine; Time Factors; Vasodilator Agents

To clarify the mechanical adaptation and interference of coronary vessels, we studied hemodynamics of coronary circulation in control and 4 different pacing rates (80, 100, 120, 150/min) in 5 patients with angina pectoris (AP) and in 5 patients with hypertrophic cardiomyopathy (HCM). Coronary sinus flow (CSF) was measured by a Webster's thermodilution catheter, and we applied ascorbic acid-platinum reaction for the mean transit time measurement in left coronary flow (t0-t2). Coronary vascular bed (CVB) was obtained by multiplying CSF and t0-t2. CSF in AP gradually increased from 104 +/- 21 ml/min at 72/min to 148 +/- 42 ml/min at 120/min, while CSF in HCM changed slightly from 91 +/- 25 ml/min at 64/min to 94 ml/min at 120/min. Average t0-t2 in HCM was 6.0 +/- 1.6 sec in control which was significantly lower than that in AP (7.8 +/- 0.7 sec). Calculated CVB in AP increased at any given heart rate up to 120/min (13.5 +/- 2.4, 15.8 +/- 1.7, 15.0 +/- 4.7, 15.1 +/- 4.3 ml), but CVB in HCM decreased from 9.1 +/- 2.3 ml at 64/min to 8.1 +/- 1.7 ml at 120/min. These data suggest that myocardial compression and suction at different heart rates and with different cardiac muscle structures play an important role for beat to beat adjustment of coronary circulation in cardiac cycle.

Topics: Adaptation, Physiological; Adult; Aged; Angina Pectoris; Ascorbic Acid; Biomechanical Phenomena; Blood Flow Velocity; Cardiac Pacing, Artificial; Cardiomegaly; Cardiomyopathy, Hypertrophic; Coronary Circulation; Coronary Vessels; Heart; Heart Rate; Hemodynamics; Humans; Middle Aged; Platinum

Cross-cultural studies suggest that low plasma antioxidant levels contribute to the high incidence of coronary heart disease (CHD) in Scotland. One hundred twenty-five cases of angina without reported history were identified by a postal WHO chest pain questionnaire from a systemic population sample of 6000 Edinburgh men (35-54 years). Classical CHD risk factors (lipids, blood pressure, smoking, and relative weight), plasma vitamins, and a new independent CHD risk factor, adipose tissue linoleate, were measured in angina (n = 125) and healthy controls (n = 430). Cigarette smoking was common in angina (46% vs. 29%, p less than 0.01), and adipose tissue linoleate was lower (8.77 +/- 0.18% vs. 9.81 +/- 0.14% (p less than 0.01). Classical CHD risk factors were not different. Vitamin E/cholesterol molar ratio (micron/mM) was lower in angina than in controls: 1.58 +/- 0.03 vs. 1.66 +/- 0.02 (p less than 0.01). Plasma vitamin C was also lower in angina than in controls: 23.6 +/- 1.7 vs. 30.5 +/- 1.1 microM (p less than 0.001). The relative risk of angina for those in the lowest versus those in the highest quintile of the vitamin E/cholesterol ratio distribution was 2.2:1, irrespective of other risk factors (p less than 0.009). Adipose tissue linoleate removed the association between vitamin E and angina. The relative risk of angina for those in the lowest versus those in the highest quintile of plasma vitamin C was 2.6:1 (p less than 0.01), and the increased risk was also independent of classical risk factors, but closely related to a smoking habit. Low plasma vitamin E or adipose linoleate predisposes to angina, and smoking may increase the risk of angina by lowering plasma vitamin C levels in Scottish men.

Topics: Adult; Angina Pectoris; Ascorbic Acid; Case-Control Studies; Humans; Male; Middle Aged; Risk Factors; Scotland; Vitamin E

Topics: Aged; Angina Pectoris; Animals; Ascorbic Acid; Cholesterol; Goats; Humans; Male

Topics: Angina Pectoris; Ascorbic Acid; Cortisone; Humans; Rutin; Vasodilator Agents

Topics: Angina Pectoris; Ascorbic Acid; Biological Evolution; Ludwig's Angina; Vitamins