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[Antioxidants and cardiovascular diseases in the Czech population]
M Bobák1, Z Skodová, P Vojtísek
1Department of Epidemiology and Public Health, University College London, Velká Británie.
Insights
Czechs have lower plasma antioxidants like beta-carotene and higher homocysteine than Brits and Bavarians, potentially explaining high cardiovascular disease rates. Low antioxidant levels, particularly beta-carotene, increased myocardial infarction risk in a case-control study.
Area of Science:
- Nutritional Epidemiology
- Cardiovascular Disease Research
- Biochemistry
Background:
- The Czech Republic exhibits high cardiovascular disease (CVD) mortality rates compared to Western European countries like Great Britain and Bavaria.
- Plasma antioxidant levels and their association with CVD risk factors are not well-established in the Czech population.
Purpose of the Study:
- To investigate the association between plasma antioxidant levels and cardiovascular disease risk in the Czech Republic.
- To compare plasma antioxidant status between Czech populations and those in countries with lower CVD mortality.
- To examine the relationship between low plasma antioxidant levels and the risk of non-fatal myocardial infarction.
Main Methods:
- Comparative analysis of plasma antioxidant levels (beta-carotene, alpha-tocopherol) and homocysteine in Czech populations versus British and Bavarian cohorts.
- Case-control study to assess the risk of myocardial infarction in relation to plasma antioxidant levels.
- Standardized conditions for blood sample collection, storage, and analysis were maintained.
Main Results:
- Czech men and women had significantly lower geometric means of beta-carotene, alpha-tocopherol, and alpha-tocopherol/total cholesterol ratio compared to British counterparts (p < 0.001).
- Czech men exhibited lower levels of alpha- and beta-carotene and lycopene, and higher homocysteine levels than Bavarian men.
- Men with below-median plasma beta-carotene levels had an elevated risk of myocardial infarction (OR 3.33), and a similar trend was observed for alpha-tocopherol (OR 1.89).
Conclusions:
- Low plasma carotenoid levels and high homocysteine in Czechs likely indicate low dietary intake of fruits and vegetables.
- Dietary factors, specifically antioxidant intake, may contribute significantly to the high cardiovascular mortality observed in the Czech Republic.
Abstract:
The authors studied the possible association between plasma antioxidants and the high rates of cardiovascular diseases in the Czech Republic. The report has three parts. First, plasma antioxidants levels were compared in a random sample of population of two Czech districts (70 men and 66 women) and in British civil servants (246 men and I 12 women). Second, plasma antioxidants were compared in random samples of men aged 45-64 in Pardubice (Czech Republic, n = 185) and Augsburg (Bavaria, n = 142). Both Breat Britain and Bavaria have substantially lower mortality from cardiovascular disease than the Czech Republic. Third, a case control study examined the relation between low levels of plasma antioxidants and the risk of non-fatal myocardial infarction (52 cases and 144 controls, all males). Blood samples were taken, stored and analysed under strictly standardised conditions. Geometric means of beta-carotene, alpha-tocopherol and the alpha-tocopherol/total cholesterol ratio were substantially lower in Czechs than in Brits (all p-values less than 0.001). For example, the mean concentration of beta carotene in plasma of Czech men was only a half of that in British men (0.39 vs. 0.77 mumol/l). Similarly, mean alpha- and beta-carotene and lycopene among Czech men were substantially lower than in Bavarian men. Mean homocysteine was higher in Czechs (10.5 mumol/l) and in Bavarians (8.9 mumol/l, p < 0.001). Means of vitamin E were similar. In the case-control study, the risk of myocardial infarction was elevated among men with below median plasma levels of beta carotene (age adjusted odds ratio 3.33, 95% confidence interval 1.43-8.33) and alfa-tocopherol (odds ratio 1.89, 95% confidence interval 0.94-3.85). The low levels of carotenoids and high levels of homocysteine in plasma of Czechs may reflect low dietary intakes of fresh fruits and vegetables. Antioxidants or factors related to their dietary intakes may be one of the causes of the high cardiovascular mortality in the Czech Republic.