Sébastien Czernichow

The object of this work was to determine the risk of hypertension after 6.5 years'- follow-up of supplementation in vitamins and antioxidant minerals at nutritional doses in the SU.VI.MAX trial. The authors also studied the association with plasma concentrations of antioxidants at inclusion and at long term. This was a randomised nutritional primary prevention study including 5086 adults of the SU.VI.MAX trial. After 6.5 years' follow-up, no effect of supplementation on the risk of developing hypertension could be shown compared with the placebo group: odds ratios (OR IC 95%): 1.04 (0.87-1.23) in men and 1.10 (0.95-1.29) in women. Besides, in the male 2nd and 3rd tertiles of serum beta-carotene levels at inclusion the risk of hypertension was lower [multivariate OR: 0.70 (0.44-1.12) and 0.53 (0.33-0.86) for placebo, and 0.59 (0.37-0.94) and 0.67 (0.42-1.07) for the supplemented groups]. The authors conclude that, despite a reverse relationship in men between the plasma concentrations of beta-carotene and the risk of hypertension, supplementation in antioxidants at nutritional doses had no effect on the risk of developing hypertension after 6.5 years' follow-up.

Few studies suggest that the combined increase in plasma triglycerides (TG) and in waist circumference (WC), termed ‘hypertriglyceridemic waist’ (HTGW), is an interesting marker of risk for cardiovascular disease (CVD). Using cutoffs used for defining HTGW, we examined the prospective association of HTGW with CVD risk in a French cohort of men. Men were participants in the SU.VI.MAX study, an intervention trial testing the impact of an antioxidant supplementation on chronic diseases. Data were collected in 1994–1996 in 3430 men followed up for 7.5 years. Cutoffs used for defining HTGW were WC 90 cm and TG 2 mmol/l. We assessed the relative risk (RR) (95% confidence interval (CI)) of CVD in groups defined according to both WC and TG levels. In this population, 41.2% of the subjects were classified as low WC/low TG, 43.2% as high WC/low TG, 3.5% as low WC/high TG and 12.1% as HTGW. During follow-up, 122 subjects had a CVD event. In this group, HTGW prevalence was 26.2%. After adjustment for age, RR (95% CI) for CVD for the HTGW group showed the highest association with CVD risk: 2.13 (1.21–3.76), using low WC/ low TG as the reference group. HTGW was associated with the risk of CVD after 7.5 years of follow-up in a low-risk middle-aged men population. This marker may be used as a useful clinical tool to screen for men at risk of CVD.

Background: Observational data suggest a protective effect of several antioxidants on fasting plasma glucose (FPG) and type 2 diabetes. However, randomized trials have yielded inconsistent results. Objectives: The first objective was to assess the effect of 7.5 y of antioxidant supplementation on FPG at 7.5 y. The second objective was to examine the epidemiologic association of baseline dietary intakes or plasma antioxidants and FPG (at baseline and at 7.5 y). Design: Subjects (n = 3146) from the Supplementation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) primary prevention trial in France were randomly assigned to receive a daily capsule containing 120 mg vitamin C, 30 mg vitamin E, 6 mg β-carotene, 100 μg Se, and 20 mg Zn or a placebo. Results: After 7.5 y, no significant difference was observed between age-adjusted mean FPG in men (P = 0.78) and women (P = 0.89) in either group. Baseline β-carotene dietary intakes and plasma concentrations were inversely associated with FPG in multivariate mixed models (P = 0.0045 and P < 0.0001, respectively). Baseline plasma vitamin C and selenium were negatively (P = 0.0455) and positively (P < 0.0001) associated, respectively, with FPG. Conclusions: Supplementation with antioxidants at nutritional doses for 7.5 y had no effect on FPG in men or women who followed a balanced diet. An inverse association of baseline β-carotene dietary intake and plasma concentrations with FPG was found, probably because β-carotene is an indirect marker of fruit and vegetable intakes.

To assess the effects of supplementation with a combination of antioxidant vitamins and trace elements, at nutritional doses, upon the 6.5-year risk of hypertension in the SU.VI.MAX trial. To describe the association between baseline plasma antioxidant levels and the same long-term risk using observational data from the study. A total of 5086 adults from the SU.VI.MAX trial, a randomized primary prevention trial. Compared with the placebo group, no effect of supplementation upon the 6.5-year risk of hypertension could be detected (odds ratio, 1.04 and 95% confidence interval, 0.87–1.23 in men; and odds ratio, 1.10 and 95% confidence interval, 0.95–1.29 in women). Furthermore, compared with men in the first tertile, those in the second and third tertiles of serum baseline levels of β-carotene presented a lower risk of hypertension in both the placebo and supplementation groups. Multivariate-adjusted odds ratios (95% confidence interval) were 0.70 (0.44–1.12) and 0.53 (0.33–0.86) in the placebo group, and were 0.59 (0.37–0.94) and 0.67 (0.42–1.07) in the supplementation group. In women, a decreasing trend was observed with vitamin C levels and risk of hypertension in the intervention group. No association could be shown between vitamin E and trace element plasma levels and the risk of hypertension. Despite an inverse association between baseline plasma levels of β-carotene in men and the risk of developing hypertension, we could not demonstrate any beneficial effect of low-dose antioxidant supplementation upon the 6.5-year risk of hypertension in the randomized analysis.

Background:. Metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease. However, the contribution of MetS to intermediate c

To investigate associations of body composition assessed by bioimpedance analysis and anthropometric indicators of fat repartition with carotid structure and function. Cross-sectional epidemiological study. SUBJECTS: A total of 1014 middle-aged apparently healthy adults participating in the SU.VI.MAX study. Body composition (fat mass, fat-free mass) was assessed by bioimpedance analysis and anthropometric indicators of fat repartition (waist circumference (WC); waist-hip-ratio (WHR)) were simultaneously collected. Carotid ultrasound examination included measurements of intima-media thickness (IMT) at the common carotid arteries (CCA) and assessment of atherosclerotic plaques in extracranial carotid arteries. Carotid-femoral pulse-wave velocity (PWV) was used as a marker of aortic stiffness. In multivariate analyses adjusted for major known cardiovascular risk factors in addition to age, gender and height, fat-free mass, fat mass (FM), and WC were positively associated with CCA-IMT and lumen diameter. No significant association was found with occurrence of carotid plaques. PWV was only associated with WC. Associations of CCA-IMT and PWV with WC were not significant anymore after further adjustment on body mass index (BMI) or FM. WC was the only measurement positively associated with both early atherosclerosis markers such as CCA-IMT and arterial stiffness. Although this association depends on overall adiposity, as assessed by the BMI, it emphasizes the importance of WC in clinical practice and prevention programs as a screening tool for individuals at risk for cardiovascular disease.