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P77 Background. In a previous report on antioxidant intake and  1.5 year progression of carotid intima-media thickness (IMT), we  reported the unexpected finding that intake of vitamin C supplements  was associated with increased IMT progression. The current paper  extends those analyses to 3 years of follow-up. Methods. The cohort of  573 employed women and men was aged 40-60 years and free of CVD at  entry. Common carotid IMT (by B-mode ultrasound), supplement intake (by  questionnaire) and food intake (by 24-hr recalls) were measured over 3  examinations at 1.5 year intervals. IMT progression at the follow-ups  (microns per year) was regressed on intake of antioxidants from  different sources (average of baseline and 1.5 year follow-up) in a  repeated measures model. Results. IMT progressed an average of 10.0  μm/yr (SD=16.5) among the 500 (87%) members of the cohort with  follow-up. After adjustment for CVD risk factors, energy intake, and  antioxidant intake from other sources, IMT progression (mean±SE)  increased from 7.6±1.8 μm/yr among persons reporting no intake of  vitamin C supplements to 20.3±2.6 μm/yr in the highest quartile of  vitamin C supplement intake (≥857 mg/day)(p-trend=0.0005). In  contrast, IMT progression declined from 10.2±1.4 μm/yr among persons  reporting no intake of vitamin E supplements to 1.5±2.8 μm/yr among  those in the highest quartile of vitamin E supplement intake (≥443  IU/day)(p-trend=0.02). Reduced progression was observed only in this  top quartile of vitamin E supplement intake. Smaller reductions in IMT  progression were also observed for high intake of vitamin C from food  (indicative of a diet rich in fruits and vegetables) and intake of  multiple vitamins (≥ 1 tablet/wk). Vitamin E from food was not  associated with IMT progression. Conclusion. Vitamin C supplements may  promote early atherosclerosis at higher doses, while vitamin E  supplement intake above 450 IU/day may block early atherosclerotic  progression. Our findings suggest that completed trials of vitamin E  and CHD may have failed to detect benefits because of insufficient dose  and intervention at later, rather than earlier, stages of  disease.

Progression of Early Atherosclerosis and Intake of Vitamin C and Vitamin E from Supplements and Food. The Los Angeles Atherosclerosis Study