Antioxidant vitamins and the risk of carotid atherosclerosis. The Perth Carotid Ultrasound Disease Assessment study (CUDAS)

J Am Coll Cardiol. 2001 Dec;38(7):1788-94. doi: 10.1016/s0735-1097(01)01676-x.


Objectives: This study examined whether dietary intake or plasma levels of antioxidant vitamins were independently associated with common carotid artery intima-media (wall) thickness (IMT) or focal plaque, or both, in a large, randomly selected community population.

Background: Oxidation of low-density lipoprotein (LDL) cholesterol is thought to be important in early atherogenesis. Antioxidant micronutrients may therefore protect against lipid peroxidation and atherosclerotic vascular disease.

Methods: We studied 1,111 subjects (558 men and 553 women; age 52 +/- 13 years [mean +/- SD], range 27 to 77). We measured dietary vitamin intake and fasting plasma levels of vitamins A, C and E, lycopene and alpha- and beta-carotene and performed bilateral carotid artery B-mode ultrasound imaging. RESULTS; After adjustment for age and conventional risk factors, there was a progressive decrease in mean IMT, with increasing quartiles of dietary vitamin E intake in men (p = 0.02) and a nonsignificant trend in women (p = 0.10). Dietary vitamin E levels accounted for 1% of the variance in measured IMT in men. For plasma antioxidant vitamins, there was an inverse association between carotid artery mean IMT and plasma lycopene in women (p = 0.047), but not in men. None of the other dietary or plasma antioxidant vitamins, nor antioxidant vitamin supplements, were associated with carotid artery IMT or focal carotid artery plaque.

Conclusions: This study provides limited support for the hypothesis that increased dietary intake of vitamin E and increased plasma lycopene may decrease the risk of atherosclerosis. No benefit was demonstrated for supplemental antioxidant vitamin use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antioxidants / administration & dosage*
  • Antioxidants / pharmacokinetics
  • Ascorbic Acid / administration & dosage
  • Ascorbic Acid / blood
  • Carotenoids / administration & dosage
  • Carotenoids / blood
  • Carotid Artery Diseases / blood
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / prevention & control
  • Health Surveys
  • Humans
  • Lycopene
  • Nutritional Requirements
  • Risk
  • Ultrasonography
  • Vitamin A / administration & dosage
  • Vitamin A / blood
  • Vitamin E / administration & dosage
  • Vitamin E / blood
  • Vitamins / administration & dosage*
  • Vitamins / blood
  • Western Australia
  • beta Carotene / administration & dosage
  • beta Carotene / blood


  • Antioxidants
  • Vitamins
  • beta Carotene
  • Vitamin A
  • Vitamin E
  • Carotenoids
  • Ascorbic Acid
  • Lycopene