BACKGROUND: Elevated cholesterol levels interfere with normal functioning of the endothelium in both adults and children. The endothelium, part of the lining of blood vessels, consists of cells that maintain vascular integrity, tone and modulate other actions that prevent atherosclerosis. Increased oxidative stress contributes to abnormal behavior of the endothelium, or endothelial dysfunction, which stiffens blood vessels, reduces blood flow, and is a known risk factor for coronary artery disease.
RESEARCH: The study included 15 subjects, ages nine to twenty, diagnosed with familial hypercholesterolemia or hyperlipidemia, an inherited condition that results in elevated cholesterol or triglyceride levels and an increased risk of early-onset heart disease. The subjects' endothelial function was abnormal at the start of the study. The seven male and eight female subjects followed a low-fat diet throughout the study period of six months. In addition to the diet, during the first six weeks, the subjects were randomized to a daily treatment of either 400 IU of vitamin E plus 500 mg of vitamin C or placebo. The next six weeks served as a washout period while all subjects consumed the low-fat diet. During the last six weeks, subjects crossed over and consumed the other regimen of vitamins E and C or placebo.
RESULTS: Supplements of vitamin E and vitamin C restored endothelial function in these hyperlipidemic children. The researchers wrote that "Early detection and treatment of endothelial dysfunction in high-risk children may retard the progression of atherosclerosis."
IMPLICATIONS: This study, like several similar ones, demonstrates that a combination of vitamins E and C may reduce the risk of heart disease in people with either elevated cholesterol levels or endothelial dysfunction, or both.
Engler MM, Engler MB, Malloy MJ, et al. Antioxidant vitamins C and E improve endothelial function in children with hyperlipidemia. Endothelial assessment of risk from lipids in youth (EARLY) trial. Circulation, 2003;108:1059-1063.
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