Serum vitamins, carotenoids, and angina pectoris: findings from the National Health and Nutrition Examination Survey III

PURPOSE: Whether various vitamins and carotenoids can protect against ischemic heart disease remains an unsettled question. METHODS: We performed a cross-sectional analysis of data from National Health and Nutrition Examination Survey III (1988-1994) and examined the associations between serum vitamins A, C, E, and B12, serum folate, red blood cell folate, serum carotenoids, and angina pectoris in a representative population-based sample of 11,327 men and women aged 35->90 years. RESULTS: After adjusting for age, sex, race or ethnicity, education, smoking status, systolic blood pressure, serum cholesterol, high-density lipoprotein cholesterol, history of diabetes mellitus, body mass index, and physical activity with multiple logistic regression analysis, no significant associations were present for any of the serum vitamin concentrations and angina pectoris. Significant linear trends were observed for serum concentrations of alpha-carotene (p < 0.001), beta-carotene (p = 0.026), and beta-cryptoxanthin (p = 0.003). Compared with participants with carotenoid concentrations in the lowest quartile, participants with concentrations in the highest quartile had odds ratios for angina pectoris of 0.45 (95% confidence interval (CI) 0.31-0.65), 0.57 (95% CI 0.38-0.86), and 0.57 (95% CI 0.38-0.84) for alpha-carotene, beta-carotene, and beta-cryptoxanthin, respectively. CONCLUSIONS: These results provide little support for a cross-sectional association between angina pectoris and serum and red blood cell folate concentrations or concentrations of vitamins A, C, E, and B12. Several serum carotenoid concentrations were associated with a reduced risk for angina pectoris, however.