Adequate vitamin C intake may be associated with longer survival of heart failure patients

Low vitamin C levels may increase the risk of complications in patients with heart failure, says a new Korean study.

In the observational study, the relationship between vitamin C intake and blood concentrations of the high sensitivity C-Reactive protein (hsCRP) – a marker for inflammation and increased risk of cardiovascular disease – was examined in 212 heart failure patients using a four-day food diary and bloods tests (1). The participants were divided into two groups (one with levels over 3 mg/L of hsCRP, and another with lower levels) and followed for one year to determine the length of time to their first visit to the emergency department due to cardiac problems or death. The study results showed that 39% of the patients had inadequate vitamin C intakes. Low vitamin C intake was associated with a higher level of hsCRP and shorter intervals without major cardiac issues or death. Participants with low vitamin C intake and hsCRP over
3 milligrams per liter (mg/L) were nearly twice as likely to die from cardiovascular disease within one year.

The researchers concluded that an adequate intake of vitamin C is associated with lower levels of high-sensitivity C-reactive protein, which seems to be linked to longer cardiac-event-free survival in patients. Randomized controlled trials and longitudinal prospective studies would be needed to determine the impact of other micronutrients on the survival or rehospitalization of heart failure patients.

Elevated concentrations of the protein hsCRP have been linked to a heightened state of inflammation in the body. Inflammation (swelling) of the arteries is a risk factor for cardiovascular diseases such as heart disease, heart attack, sudden death, stroke, and peripheral arterial disease. The Physicians Health Study, a clinical trial involving 18,000 apparently healthy physicians, was the first large study to show that elevated levels of CRP were associated with a threefold increase in the risk of heart attack (2).

1. Song E. K. et al. Vitamin C Deficiency, High-Sensitivity C-Reactive Protein, and Cardiac Event-Fee Survival in Patients with Heart Failure. American Heart Association's Scientific Sessions 2011; Issues in Heart Failure Management: Abstract 14667.
   
   
2. Ridker P. M. et al. C-Reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction. Circulation. 1998; 97:2007–2011.