Vitamin C preserves endothelial function in patients with coronary heart disease after a high-fat meal

Clin Cardiol. 2002 May;25(5):219-24. doi: 10.1002/clc.4950250505.


Background: It has been suggested that an oxidative mechanism is involved with the impaired endothelium-dependent vasodilatation that occurs after a high-fat meal.

Hypothesis: The study was undertaken to evaluate the effect of a single oral dose of vitamin C (2 g) on postprandially impaired endothelium-dependent vasodilatation in patients with coronary heart disease (CHD).

Methods: This study included 74 patients with CHD and 50 subjects without CHD with risk factors. The two groups were divided into two subgroups that did or did not receive 2 g of vitamin C (CHD/VitC and CHD/control, n = 37; non-CHD/VitC and non-CHD/control, n = 25) after a high-fat meal (800 calories, 50 g fat). Serum levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in the fasting state and at 2, 4, 5, and 7 h after the high-fat meal were measured. Endothelial function was assessed in the brachial artery by high-resolution ultrasound at baseline and at 4 h postprandially.

Results: The postprandial serum triglyceride concentration increased significantly at 2-5 h after the high-fat meal in all groups. The fasting flow-mediated dilatation (FMD) (p < 0.02) and nitroglycerin-induced dilatation (NID) (p < 0.05) of patients with CHD were impaired compared with those of non-CHD subjects. Postprandial FMD was significantly aggravated in the non-CHD/control group (p < 0.01) and the CHD/control group (p < 0.001), but the postprandial FMD in patients and subjects taking vitamin C showed no significant change, although the CHD/VitC group had a mild tendency toward improvement (p = 0.064) and non-CHD/VitC group had a mild tendency toward aggravation (p = 0.852). The change of NID after a high-fat meal did not reach statistical significance in the four groups. The decrement of postprandial FMD correlated positively with the increment of 2-h serum triglyceride concentration in the patients without vitamin C (n = 62, r = 0.545, p < 0.001).

Conclusions: The postprandial state after a high-fat meal is critical in atherogenesis, as it induces endothelial dysfunction through an oxidative stress mechanism. Vitamin C treatment has a promising benefit for patients with CHD.

MeSH terms

  • Administration, Oral
  • Analysis of Variance
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage*
  • Brachial Artery / physiology
  • Case-Control Studies
  • Chi-Square Distribution
  • Coronary Disease / physiopathology*
  • Dietary Fats / adverse effects
  • Dietary Fats / pharmacology*
  • Endothelium, Vascular / physiology*
  • Female
  • Humans
  • Lipids / blood
  • Male
  • Middle Aged
  • Oxidative Stress
  • Postprandial Period
  • Risk Factors
  • Vasodilation / physiology


  • Antioxidants
  • Dietary Fats
  • Lipids
  • Ascorbic Acid