title: Low β-carotene concentrations increase the risk of cardiovascular disease mortality among Finnish men with risk factors.
abstract: OBJECTIVE
  Healthy diet rich in fruits and vegetables is an important factor in prevention of cardiovascular diseases (CVD). Some previous epidemiological studies have suggested that dietary and serum carotenoids are associated with decreased CVD mortality, but the results have been inconsistent. We assessed relations between the concentrations of serum carotenoids and CVD mortality among Eastern Finnish men.
  
  
  RESULTS
  The study population consisted of 1031 Eastern Finnish men aged 46-65 years in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) cohort. Subjects were classified quartiles according to concentrations of carotenoids and subgroups according to risk factors. Hazard ratios of serum lycopene, α-carotene and β-carotene were estimated by the Cox proportional hazard model after adjusting for potential confounding factors. During the median 15.9-year follow-up, 122 deaths from CVDs, were identified among the cohort subjects. Low serum concentrations of β-carotene were strongly related to an increased CVD mortality risk after adjustment for confounders. For β-carotene, the hazard ratio (95% confidence interval) for the lowest versus highest quartile was 2.23 (1.26-3.93; P=0.006). However, the strongest risk of CVD mortality was observed among smokers with lowest levels of β-carotene (HR=3.15, 95%, CI: 1.19-8.33; P=0.020). Other carotenoids and the sum of carotenoids were not significantly related to increased risk of CVD mortality.
  
  
  CONCLUSIONS
  Low concentrations of serum β-carotene concentrations may increase the risk for CVD mortality among Eastern Finnish men; thus elevated serum concentrations of β-carotene may have clinical and public health relevance.
authors.affiliation: University of Eastern Finland, Department of Medicine, Institute of Public Health and Clinical Nutrition, FI-70211 Kuopio, Finland. jouni.karppi@uef.fi
authors.forename: J
authors.initials: J
authors.lastname: Karppi
authors.forename: J A
authors.initials: JA
authors.lastname: Laukkanen
authors.forename: T H
authors.initials: TH
authors.lastname: Mäkikallio
authors.forename: K
authors.initials: K
authors.lastname: Ronkainen
authors.forename: S
authors.initials: S
authors.lastname: Kurl
mesh_terms: D000328:Adult; D002338:Carotenoids / Q000097:blood; D004032:Diet; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D000077276:Lycopene; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality* / Q000517:prevention & control*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables; D044465:White People; D019207:beta Carotene / Q000097:blood*
chemical_list: D019207:beta Carotene; D002338:Carotenoids; C041635:alpha-carotene; D000077276:Lycopene