Cardiovascular Diseases Clinical Trial
Official title:
Antioxidants and Prevention of Early Atherosclerosis
This study will evaluate the effects of vitamin E supplementation in retarding the progression of common carotid artery intima-media thickening in African Americans.
BACKGROUND:
Evidence from epidemiologic studies, and from one unpublished study, suggests that greater
intake of antioxidant vitamins is associated with reduced risk of coronary heart disease and
stroke. Findings from an animal model indicate that increased intake of antioxidant vitamins
prevents progression of aortic fatty streaks induced by an atherogenic diet, but not from
more advanced injury-induced lesions. These observations suggest the hypothesis that
increased antioxidant vitamin intake may prevent further progression of early
atherosclerosis, possibly by means of reduced susceptibility of low density lipoprotein to
oxidative modification and consequent cytotoxic, chemotactic, chemostatic, and unregulated
uptake effects.
A new, automated, low-cost, portable ultrasound system for determining intima-media
thickness of the common carotid artery makes it feasible to test the primary prevention
impact of antioxidant vitamins on early atherosclerosis. Results of two studies at the
University of Southern California suggest that the low-density lipoprotein effects on common
carotid artery intima-media thickness can be detected by automated methods within 12 to 24
months in small patient samples. Retardation of intima-media thickness progression was
achieved in both studies without significant changes in average vessel diameter, which
suggests effects on early atherosclerotic lesions.
DESIGN NARRATIVE:
Patients will be screened for carotid intima-media thickness at home or at schools in mobile
vans equipped with portable ultrasound equipment. After 12 months, those patients above the
age and sex-adjusted 66th percentile at Screen I will be re-screened (Screen II), and those
showing the greatest progression in intima-media thickness will be invited to participate in
a trial run-in to assess vitamin E compliance. Patients will be randomized to the following
four groups: 1) vitamin E (573 mg/day); 2) vitamin C; 3) Vitamin E and C combined; and 4)
placebo. Common carotid artery intima-media thickness will be observed by ultrasound at 12-
and 24-month follow-ups. The primary outcome is 24-month rate of change in average common
carotid artery intima-media thickness.
The study completion date listed in this record was obtained from the Query/View/Report
(QVR) System.
;
Allocation: Randomized, Primary Purpose: Prevention
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