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Antioxidant Vitamin Supplementation Reduces Arterial Stiffness in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Lookup NU author(s): Ammar Ashor, Dr Mario Siervo, Dr Jose Lara-Gallegos, Dr Clio Oggioni, Professor John Mathers


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Background: Several studies tested the effects of supplementation with antioxidant vitamins on arterial stiffness, but the results were contradictory.Objectives: The aim of our study was to conduct a systematic review and meta-analysis investigating the effect of antioxidant vitamins on arterial stiffness and to determine whether the effects on arterial stiffness vary according to dose, duration of intervention, and health or nutritional status of the included participants.Methods: We searched 3 databases (Medline, Embase, and Scopus) for articles that potentially met the following eligibility criteria: 1) randomized controlled trials comparing antioxidant vitamins (vitamins C, E, and A and beta-carotene), to either placebo or no active control in 21 adult participants aged >= 18 y; 3) antioxidant vitamins administered alone or in combination, irrespective of dose, duration, and route of administration; and 4) changes in arterial stiffness or arterial compliance. Data were pooled as standardized mean differences (SMDs) and analyzed using fixed- and random-effects models.Results: Data synthesis showed that antioxidant vitamins reduced arterial stiffness significantly (SMD: -0.17; 95% Cl: -0.26, -0.08; P < 0.001). This effect was significant in experimental (SMD: -1.02,95% Cl: -1.54, -0.49; P < 0.001) and primary prevention (SMD. -0.14; 95% Cl: -0.24, -0.04; P < 0.01) studies, whereas a trend for reduced arterial stiffness was observed in studies including participants with diseases (SMD: -0.19; 95% Cl: -0.40, 0.02; P = 0.08). Vitamin supplementation improved arterial stiffness irrespective of age group and duration of intervention. Antioxidant vitamins were more effective in participants with low baseline plasma concentrations of vitamins C (SMD: -0.35; 95% Cl: -0.62, -0.07. P < 6.016) and E (SMD: 0:79; 95% Cl: -1.23, -0.33; P < 0.01).Conclusions: Supplementation with antioxidant vitamins has a small, protective effect on arterial stiffness. The effect may be augmented in those with lower baseline plasma vitamin E and C concentrations. This trial was registered at PROSPERO as CRD42014007260.

Publication metadata

Author(s): Ashor AW, Siervo M, Lara J, Oggioni C, Mathers JC

Publication type: Article

Publication status: Published

Journal: Journal of Nutrition

Year: 2014

Volume: 144

Issue: 10

Pages: 1594-1602

Print publication date: 01/10/2014

Online publication date: 06/08/2014

Acceptance date: 11/07/2014

Date deposited: 25/01/2016

ISSN (print): 0022-3166

ISSN (electronic): 1541-6100

Publisher: American Society for Nutrition


DOI: 10.3945/jn.114.195826


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Funder referenceFunder name
G0700718Medical Research Council
G0900686Medical Research Council