Vitamin c status and undiagnosed angina

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.