Vitamin E and Cardiovascular Disease: Observational Studies

Evidence that fruit and vegetables may protect against coronary heart disease is accumulating. It is unclear which constituents of fruit and vegetables are responsible for this protective effect. Folate as a co-substrate in homocysteine metabolism may be important. An intake of about 400 mug folate equivalents/day seems to be required to achieve stable low homocysteine blood levels. Five of eight epidemiologic studies show significant inverse associations between folate and cardiovascular disease. These associations could be confounded by antioxidant vitamins and/or other substances. In trials examining an association between folate and cardiovascular disease such confounding must be excluded, before specific recommendations can be given. Observational studies suggest that vitamin C plays a role in the aetiology of cardiovascular disease, but there are no completed intervention trials of this vitamin alone. With regard to vitamin E two cohort studies point to cardiovascular benefits with the long-term use of supplements of at least 100 IU/day, but the results of controlled trials are inconclusive. There is some evidence from observational studies of an inverse association between beta-carotene and cardiovascular disease, particularly in smokers. Intervention trials do not support this hypothesis, rather, they suggest a possible harmful effect of beta-carotene supplements in smokers. Nevertheless, protective effects of beta-carotene and vitamin E in different dosages, durations of administration, or different combinations, are still possible. The last paragraph of this review discusses limitations of the present and priorities of future research.

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Circulating Stem/Progenitor Cells as Prognostic Biomarkers in Macro- and Microvascular Disease: A Narrative Review of Prospective Observational Studies

Current Medicinal Chemistry ◽

10.2174/0929867324666170920154020 ◽

2018 ◽

Vol 25 (35) ◽

pp. 4507-4517 ◽

Cited By ~ 6

Author(s):

Mauro Rigato ◽

Gian Paolo Fadini

Keyword(s):

Cardiovascular Disease ◽

Progenitor Cells ◽

Cardiovascular Events ◽

Observational Studies ◽

English Language ◽

Microvascular Disease ◽

Patient Characteristics ◽

Diabetic Patients ◽

Increased Risk ◽

Cell Phenotypes

Background: Circulating progenitor cells (CPCs) and endothelial progenitor cells (EPCs) are immature cells involved in vascular repair and related to many aspects of macro and microvascular disease. <p> Objective: We aimed to review studies reporting the prognostic role of CPCs/EPCs measurement on development of cardiovascular disease and microangiopathy. <p> Methods and Results: We reviewed the English language literature for prospective observational studies reporting the future development of cardiovascular disease or microangiopathy in patients having a baseline determination of CPCs/EPCs. We retrieved 34 studied reporting on cardiovascular outcomes and 2 studies reporting on microvascular outcomes. Overall, a reduced baseline level of CPCs/EPCs was associated with a significant increased risk of cardiovascular events, all-cause death, and onset/progression of microangiopathy. The most predictive phenotypes were CD34+ and CD34+CD133+. The main limitation was related to the high heterogeneity among studies in terms of patient characteristics and cell phenotypes. <p> Conclusion: The present review shows that a reduced level of circulating progenitor cells is a risk factor for the development of future cardiovascular events and death. In addition, low CPCs/EPCs levels predict the onset or worsening of microalbuminuria and retinopathy in diabetic patients.

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Dietary and circulating vitamin C, vitamin E, β-carotene and risk of total cardiovascular mortality: a systematic review and dose–response meta-analysis of prospective observational studies

Public Health Nutrition ◽

10.1017/s1368980018003725 ◽

2019 ◽

Vol 22 (10) ◽

pp. 1872-1887 ◽

Cited By ~ 8

Author(s):

Ahmad Jayedi ◽

Ali Rashidy-Pour ◽

Mohammad Parohan ◽

Mahdieh Sadat Zargar ◽

Sakineh Shab-Bidar

Keyword(s):

Systematic Review ◽

Vitamin E ◽

Vitamin C ◽

Dose Response ◽

Observational Studies ◽

Meta Analysis ◽

Dietary Intakes ◽

Relative Risks ◽

Β Carotene ◽

Cvd Mortality

AbstractObjectiveThe present review aimed to quantify the association of dietary intake and circulating concentration of major dietary antioxidants with risk of total CVD mortality.DesignSystematic review and meta-analysis.SettingSystematic search in PubMed and Scopus, up to October 2017.ParticipantsProspective observational studies reporting risk estimates of CVD mortality across three or more categories of dietary intakes and/or circulating concentrations of vitamin C, vitamin E and β-carotene were included. A random-effects meta-analysis was conducted.ResultsA total of fifteen prospective cohort studies and three prospective evaluations within interventional studies (320 548 participants and 16 974 cases) were analysed. The relative risks of CVD mortality for the highest v. the lowest category of antioxidant intakes were as follows: vitamin C, 0·79 (95 % CI 0·68, 0·89; I2=46 %, n 10); vitamin E, 0·91 (95 % CI 0·79, 1·03; I2=51 %, n 8); β-carotene, 0·89 (95 % CI 0·73, 1·05; I2=34 %, n 4). The relative risks for circulating concentrations were: vitamin C, 0·60 (95 % CI 0·42, 0·78; I2=65 %, n 6); α-tocopherol, 0·82 (95 % CI 0·76, 0·88; I2=0 %, n 5); β-carotene, 0·68 (95 % CI 0·52, 0·83; I2=50 %, n 6). Dose–response meta-analyses demonstrated that the circulating biomarkers of antioxidants were more strongly associated with risk of CVD mortality than dietary intakes.ConclusionsThe present meta-analysis demonstrates that higher vitamin C intake and higher circulating concentrations of vitamin C, vitamin E and β-carotene are associated with a lower risk of CVD mortality.

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Coffee Consumption and Cardiovascular Diseases: A Mendelian Randomization Study

Nutrients ◽

10.3390/nu13072218 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2218

Author(s):

Shuai Yuan ◽

Paul Carter ◽

Amy M. Mason ◽

Stephen Burgess ◽

Susanna C. Larsson

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Diseases ◽

Intracerebral Hemorrhage ◽

Genetic Variants ◽

Odds Ratio ◽

Observational Studies ◽

Mendelian Randomization ◽

Coffee Consumption ◽

Uk Biobank ◽

The Uk

Coffee consumption has been linked to a lower risk of cardiovascular disease in observational studies, but whether the associations are causal is not known. We conducted a Mendelian randomization investigation to assess the potential causal role of coffee consumption in cardiovascular disease. Twelve independent genetic variants were used to proxy coffee consumption. Summary-level data for the relations between the 12 genetic variants and cardiovascular diseases were taken from the UK Biobank with up to 35,979 cases and the FinnGen consortium with up to 17,325 cases. Genetic predisposition to higher coffee consumption was not associated with any of the 15 studied cardiovascular outcomes in univariable MR analysis. The odds ratio per 50% increase in genetically predicted coffee consumption ranged from 0.97 (95% confidence interval (CI), 0.63, 1.50) for intracerebral hemorrhage to 1.26 (95% CI, 1.00, 1.58) for deep vein thrombosis in the UK Biobank and from 0.86 (95% CI, 0.50, 1.49) for subarachnoid hemorrhage to 1.34 (95% CI, 0.81, 2.22) for intracerebral hemorrhage in FinnGen. The null findings remained in multivariable Mendelian randomization analyses adjusted for genetically predicted body mass index and smoking initiation, except for a suggestive positive association for intracerebral hemorrhage (odds ratio 1.91; 95% CI, 1.03, 3.54) in FinnGen. This Mendelian randomization study showed limited evidence that coffee consumption affects the risk of developing cardiovascular disease, suggesting that previous observational studies may have been confounded.

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Relevance of the Glycemic Index and Glycemic Load for Body Weight, Diabetes, and Cardiovascular Disease

Nutrients ◽

10.3390/nu10101361 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1361 ◽

Cited By ~ 31

Author(s):

Sonia Vega-López ◽

Bernard Venn ◽

Joanne Slavin

Keyword(s):

Cardiovascular Disease ◽

Body Weight ◽

Health Outcomes ◽

Glycemic Index ◽

Observational Studies ◽

Intervention Studies ◽

Disease Risk ◽

Glycemic Load ◽

Dietary Quality ◽

The Relationship

Despite initial enthusiasm, the relationship between glycemic index (GI) and glycemic response (GR) and disease prevention remains unclear. This review examines evidence from randomized, controlled trials and observational studies in humans for short-term (e.g., satiety) and long-term (e.g., weight, cardiovascular disease, and type 2 diabetes) health effects associated with different types of GI diets. A systematic PubMed search was conducted of studies published between 2006 and 2018 with key words glycemic index, glycemic load, diabetes, cardiovascular disease, body weight, satiety, and obesity. Criteria for inclusion for observational studies and randomized intervention studies were set. The search yielded 445 articles, of which 73 met inclusion criteria. Results suggest an equivocal relationship between GI/GR and disease outcome. The strongest intervention studies typically find little relationship among GI/GR and physiological measures of disease risk. Even for observational studies, the relationship between GI/GR and disease outcomes is limited. Thus, it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes. Other measures of dietary quality, such as fiber or whole grains may be more likely to predict health outcomes. Interest in food patterns as predictors of health benefits may be more fruitful for research to inform dietary guidance.

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Abstract P135: Covid-19 And Hypertension: Pooled Analysis Of Observational Studies

Hypertension ◽

10.1161/hyp.76.suppl_1.p135 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Vikramaditya Reddy Samala Venkata ◽

Rahul Gupta ◽

Surya Kiran Aedma

Keyword(s):

Diabetes Mellitus ◽

Cardiovascular Disease ◽

Severe Acute Respiratory Syndrome ◽

Clinical Outcomes ◽

Random Effects ◽

Observational Studies ◽

Retrospective Studies ◽

Pooled Analysis ◽

Random Effects Model ◽

Electronic Search

Introduction: The pandemic of COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 infection. Although clinical data is limited, studies published so far raise concerns about an association between hypertension and worse clinical outcomes in COVID-19. Our aim was to assess the association between hypertension and mortality in COVID-19 patients. Methods: A systematic electronic search was performed in PubMed, Embase, and Google Scholar. Retrospective studies with original COVID-19 hospitalized patient data and reporting prevalence of hypertension was included in our study. Pooled analysis using a random-effects model was performed to look at the association between hypertension and mortality. Results: 22 studies from 8 countries with over 11,000 patients were included in our analysis. Hypertension was the most prevalent comorbidity in hospitalized COVID-19 patients (42%), followed by diabetes mellitus (23%)(Figure 1). Hypertension by itself was associated with higher rates of mortality (Figure 2). Other less prevalent comorbidities include non-hypertensive cardiovascular disease (11%), CKD (6%), CVA (5%), COPD (4.3%). Conclusion: Hypertension is the most prevalent comorbidity in hospitalized COVID-19 patients, followed by diabetes mellitus and was found to be significantly associated with higher rates of mortality. Surprisingly, hypertension is significantly more common than COPD in this population. The reason for this is unclear, there is no evidence currently that hypertension is directly related to mortality in this population. More randomized studies are needed to assess the effect of hypertension on mortality in COVID-19 patients.

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Obtaining Robust Causal Evidence from Observational Studies: Can Genetic Epidemiology Help?

Causality and Psychopathology ◽

10.1093/oso/9780199754649.003.0014 ◽

2011 ◽

Author(s):

George Davey Smith

Keyword(s):

Vitamin E ◽

New England ◽

Observational Studies ◽

Hormone Replacement ◽

Developed Countries ◽

Epidemiological Studies ◽

Health Study ◽

High Profile ◽

Chd Risk

Observational epidemiological studies have clearly made important contributions to understanding the determinants of population health. However, there have been high-profile problems with this approach, highlighted by apparently contradictory findings emerging from observational studies and from randomized controlled trials (RCTs) of the same issue. These situations, of which the best known probably relates to the use of hormone-replacement therapy (HRT) in coronary heart disease (CHD) prevention, have been discussed elsewhere (Davey Smith & Ebrahim, 2002) . The HRT controversy is covered elsewhere in this volume (see Chapter 5). Here, I will discuss two examples. First, consider the use of vitamin E supplements and CHD risk. Several observational studies have suggested that the use of vitamin E supplements is associated with a reduced risk of CHD, two of the most influential being the Health Professionals Follow-Up Study (Rimm et al., 1993) and the Nurses’ Health Study (Stampfer et al., 1993), both published in the New England Journal of Medicine in 1993. Findings from one of these studies are presented in Figure 9.1, where it can be seen that even short-term use of vitamin E supplements was associated with reduced CHD risk, which persisted after adjustment for confounding factors. demonstrates that nearly half of U.S. adults are taking either vitamin E supplements or multivitamin/multimineral supplements that generally contain vitamin E (Radimer et al., 2004). presents data from three available time points, where there appears to have been a particular increase in vitamin E use following 1993 (Millen, Dodd, & Subar, 2004), possibly consequent upon the publication of the two observational studies already mentioned, which have received nearly 3,000 citations between them since publication. The apparently strong observational evidence with respect to vitamin E and reduced CHD risk, which may have influenced the very high current use of vitamin E supplements in developed countries, was unfortunately not realized in RCTs, in which no benefit from vitamin E supplementation use is seen.

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