Published Online
on August 4, 2003

A more recent version of this article appeared on August 19, 2003

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Submitted on January 18, 2003
Revised on May 15, 2003
Accepted on May 15, 2003

Plasma Carotenoids and Tocopherols and Risk of Myocardial Infarction in a Low-Risk Population of US Male Physicians

A. Elisabeth Hak MD, PhD, Meir J. Stampfer MD, DrPH, Hannia Campos PhD, Howard D. Sesso DSc, J. Michael Gaziano MD, Walter Willett MD, DrPH, and Jing Ma MD, PhD^*

From the Departments of Epidemiology (A.E.H., M.S.J., W.W.) and Nutrition (M.J.S., H.C., W.W.), Harvard School of Public Health; Channing Laboratory (M.J.S., W.W., J.M.) and Divisions of Preventive Medicine and Aging (H.D.S., J.M.G.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; and VA Boston Healthcare System (J.M.G.), Boston, Mass; and the Departments of Epidemiology and Biostatistics and Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (A.E.H.).

^* To whom correspondence should be addressed. E-mail: jing.ma{at}channing.harvard.edu.

Background--Increased intake of carotenoids and vitamin E may protect against myocardial infarction (MI). However, prospective data on blood levels of carotenoids other than -carotene and vitamin E (tocopherol) and risk of MI are sparse.

Methods and Results--We conducted a prospective, nested case-control analysis among male physicians without prior history of cardiovascular disease who were followed for up to 13 years in the Physicians' Health Study. Samples from 531 physicians diagnosed with MI were analyzed together with samples from paired control subjects, matched for age and smoking, for 5 major carotenoids (- and -carotene, -cryptoxanthin, lutein, and lycopene), retinol, and - and -tocopherol. Overall, we found no evidence for a protective effect against MI for higher baseline plasma levels of retinol or any of the carotenoids measured. Among current and former smokers but not among never-smokers, higher baseline plasma levels of -carotene tended to be associated with lower risk (P for interaction=0.02). Men with higher plasma levels of -tocopherol tended to have an increased risk of MI (P for trend=0.01).

Conclusions--These prospective data do not support an overall protective relation between plasma carotenoids or tocopherols and future MI risk among men without a history of prior cardiovascular disease.

Key words: antioxidants • cardiovascular diseases • plasma • myocardial infarction

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