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Low vitamin C intake associated with worse outcomes for HF patients

Issue: December 2011

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AHA Scientific Sessions 2011

ORLANDO, Fla. — Patients with heart failure and low levels of vitamin C appear to also have higher levels of high-sensitivity C-reactive protein and shorter intervals without major cardiac issues or death.

Researchers reported results of a new study demonstrating that patients with HF and inadequate vitamin C intake were 2.4 times more likely to have higher levels of high-sensitivity C-reactive protein (hsCRP) compared with patients who had adequate intake.

This study is the first to demonstrate that low vitamin C intake is associated with worse outcomes for patients with HF, according to Eun Kyeung Song, PhD, RN, and colleagues.

Researchers studied 212 patients with HF (mean age, 61 years; 34% women; 45% NYHA class III/IV). Participants completed a 4-day food diary verified by a registered dietitian. A software program was used to calculate vitamin C intake and blood tests measured hsCRP. Researchers divided participants into two groups: those with hsCRP levels .3 mg/L and those with levels <3 mg/L.

Overall, 39% of patients had inadequate vitamin C intake, according to criteria set by the Institute of Medicine. Nearly half (46%) had hsCRP levels >3 mg/L.

After 1 year of follow-up, 29% of patients experienced cardiac events, including an ED visit and hospitalization, or death. In addition, low vitamin C intake (HR=2.0; 95% CI, 1.15-3.42) and hsCRP >3 mg/L (HR=1.9; 95% CI, 1.07-3.48) predicted shorter event-free survival after controlling for age, sex, BMI, NYHA class, ejection fraction, comorbidities, total caloric intake and medications, according to the results.

"We found that adequate intake of vitamin D was associated with longer survival in patients with HF," Song, assistant professor in the department of nursing, College of Medicine, University of Ulsan, Korea, said at a press release.

Inflammatory pathways in patients with HF may be why vitamin C deficiency contributed to poor health outcomes, the researchers said. The use of diuretics may also play a role, according to researcher Terry Lennie, PhD, RN, associate dean of PhD studies, College of Nursing, University of Kentucky. "Eating the recommended five servings of fruit and vegetables a day provides an adequate amount of vitamin C," Lennie said.

For more information:

• Song E. Abstract #14667. Presented at: Presented at: American Heart Association Scientific Sessions 2011; Nov. 12-16, 2011; Orlando, Fla.

Disclosure: Dr. Song reports no relevant financial disclosures. Dr. Lennie has received a research grant and multiple extramural funding in this area.

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