Does vitamin C deficiency increase lifestyle-associated vascular disease progression? Evidence based on experimental and clinical studies

Antioxid Redox Signal. 2013 Dec 10;19(17):2084-104. doi: 10.1089/ars.2013.5382. Epub 2013 Jun 20.


Significance: Despite continuous advances in the prevention of cardiovascular disease (CVD), critical issues associated with an unhealthy lifestyle remain an increasing cause of morbidity and mortality in industrialized countries.

Recent advances: A growing body of literature supports a specific role for vitamin C in a number of reactions that are associated with vascular function and control including, for example, nitric oxide bioavailability, lipid metabolism, and vascular integrity.

Critical issues: A large body of epidemiological evidence supports a relationship between poor vitamin C status and increased risk of developing CVD, and the prevalence of deficiency continues to be around 10%-20% of the general Western population although this problem could easily and cheaply be solved by supplementation. However, large intervention studies using vitamin C have not found a beneficial effect of supplementation. This review outlines the proposed mechanism by which vitamin C deficiency worsens CVD progression. In addition, it discusses problems with the currently available literature, including the discrepancies between the large intervention studies and the experimental and epidemiological literature.

Future directions: Increased insights into vitamin C deficiency-mediated CVD progression will enable the design of future randomized controlled trials that are better suited to test the efficacy of vitamin C in disease prevention as well as the identification of high-risk individuals which could possibly benefit from supplementation.

Publication types

  • Review

MeSH terms

  • Animals
  • Antioxidants / therapeutic use
  • Ascorbic Acid / therapeutic use
  • Ascorbic Acid Deficiency / complications
  • Ascorbic Acid Deficiency / pathology*
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / pathology*
  • Diabetes Mellitus, Type 2 / complications
  • Disease Progression
  • Humans
  • Life Style
  • Obesity / complications
  • Oxidation-Reduction
  • Randomized Controlled Trials as Topic
  • Smoking / adverse effects


  • Antioxidants
  • Ascorbic Acid