Cited by 582Cardiovascular Health and Disease PreventionNitric Oxide and Endothelin EffectsAntioxidant Activity and Oxidative Stress

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Ascorbic Acid Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease

Levine, Glenn N., Frei, Balz, Koulouris, Spyridon N., Gerhard, Marie D., Keaney, John F., Vita, Joseph A.·1996·Circulation

DOI 10.1161/01.cir.93.6.1107

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Abstract

Background In the setting of atherosclerosis, endothelial vasomotor function is abnormal. Increased oxidative stress has been implicated as one potential mechanism for this observation. We therefore hypothesized that an antioxidant, ascorbic acid, would improve endothelium-dependent arterial dilation in patients with coronary artery disease. Methods and Results Brachial artery endothelium-dependent dilation in response to hyperemia was assessed by high-resolution vascular ultrasound before and 2 hours after oral administration of either 2 g ascorbic acid or placebo in a total of 46 patients with documented coronary artery disease. Plasma ascorbic acid concentration increased 2.5-fold 2 hours after treatment (46±8 to 114±11 μmol/L, P =.001). In the prospectively defined group of patients with an abnormal baseline response (<5% dilation), ascorbic acid produced marked improvement in dilation (2.0±0.6% to 9.7±2.0%), whereas placebo had no effect (1.1±1.5% to 1.7±1.5%, P =.003 for ascorbic acid versus placebo). Ascorbic acid had no effect on hyperemic flow or arterial dilation to sublingual nitroglycerin. Conclusions Ascorbic acid reverses endothelial vasomotor dysfunction in the brachial circulation of patients with coronary artery disease. These findings suggest that increased oxidative stress contributes to endothelial dysfunction in patients with atherosclerosis and that endothelial dysfunction may respond to antioxidant therapy.

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Authors: Levine, G. N., Frei, B., Koulouris, S. N., Gerhard, M. D., Keaney, J. F., & Vita, J. A.
Affiliations: Boston University (US)
ORCID: Levine, Glenn N.
Keaney, John F.
Vita, Joseph A.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1996-03-15
Volume: 93
Issue: 6
Pages: 1107-1113
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.93.6.1107
OpenAlex: W2035433779
Cited by: 582
References: 53
Citations by year: 2026: 2 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 5 · 2019: 12 · 2018: 8 · 2017: 12 · 2016: 7 · 2015: 14 · 2014: 6 · 2013: 14 · 2012: 12
FWCI: 34.16
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion, public-domain)
PubMed (publishedVersion)
Funders: National Institutes of Health (1f32hl008635-01, 7r29hl049954-05, 1r01hl053398-01a1)
National Heart, Lung, and Blood Institute (HL 53398, HL-08635, HL49954)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
Keywords: vitamin C, endothelial dysfunction, endothelium-dependent vasodilation, coronary artery disease, oxidative stress, antioxidant therapy, brachial artery, atherosclerosis, hyperemic flow
MeSH terms: Adult, Aged, Aged, 80 and over, Antioxidants, Ascorbic Acid, Coronary Circulation, Coronary Disease, Endothelium, Vascular, Female, Humans, Male, Middle Aged, Nitric Oxide, Vasodilation

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Ascorbic Acid Reverses Endothelial Vasomotor Dysfunction in Patients With Coronary Artery Disease

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