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Vitamin C Intake and Risk of Ischemic Heart Disease in a Population with a High Prevalence of Smoking

Department of Preventive Medicine and Public Health (C.M.N., K.H.L., I.S.)
Department of Internal Medicine (S.Y.C., W.H.S.), Yonsei University College of Medicine
Department of Public Health, Graduate School of Yonsei University (K.W.O.)
Department of Epidemiology and Health Promotion, Graduate School of Health Science and Management (S.H.J.), Yonsei University, Seoul, KOREA

Address reprint requests to: Il Suh, MD, PhD, Department of Preventive Medicine and Public Health, Yonsei University College of Medicine 134 Shinchon-dong Seodaemun-gu 120-752 Seoul, Republic of Korea. E-mail: isuh{at}yumc.yonsei.ac.kr

Objective: Epidemiological data on the relationship between vitamin C intake and ischemic heart disease (IHD) risk are limited in the Asian population, with a high prevalence of smoking. This study aims to investigate the association between vitamin C intake and the incidence of non-fatal IHD in Korean men.

Methods: The case group consisted of 108 patients with electrocardiogram-confirmed myocardial infarction or angiographically confirmed (50% stenosis) coronary artery disease (CAD) who were admitted to a university teaching hospital in Seoul, Korea. The controls were 142 age-matched patients admitted to the departments of ophthalmology and orthopedic surgery at the same hospital. Vitamin C intake was assessed by a nutritionist using a semi-quantitative food frequency method, and body mass index (BMI), tobacco use and past history of cardiovascular disease were determined by examination and interview.

Results: After controlling for cardiovascular risk factors, including BMI, smoking, past history of hypertension, past history of hyperlipidemia, dietary intakes of energy, total fat (or subtype of fat), cholesterol, ß-carotene, and vitamin E, the odds ratio (OR) of non-fatal IHD was 0.34 (95% confidence interval (CI) 0.13–0.90) in the highest tertile of vitamin C intake compared with those in the lowest tertile. In a subgroup analysis, which compared nonsmokers in the highest tertile of vitamin C intake to current smokers in the lowest tertile of vitamin C intake, the odds ratio of developing non-fatal IHD was 0.12 (95% CI 0.02–0.77).

Conclusion: This study suggests that higher intake of vitamin C is associated with the decreased risk of non-fatal IHD in a population with a high prevalence of smoking.

Key words: vitamin C intake, Ischemic heart disease, case-control study, Republic of Korea

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