title: Plasma vitamin C and risk of hospitalisation with diagnosis of atrial fibrillation in men and women in EPIC-Norfolk prospective study.
abstract: BACKGROUND
  Fruit and vegetable intake has been associated with lower risk for cardiovascular risk factors and disease. Data on its association with atrial fibrillation are lacking.
  
  
  RESULTS
  We examined the prospective association of plasma vitamin C concentration as a biomarker for fruit and vegetable intake with the risk of hospitalisation with diagnosis of atrial fibrillation in apparently healthy 8,760 men and 10,530 women aged 39-79 participating in the EPIC-study in Norfolk. The hazard ratios of atrial fibrillation comparing each quartile of plasma vitamin C concentration with the lowest were 0.76 (95% CI 0.57-1.00), 0.73 (95% CI 0.55-0.98) and 0.77 (95% CI 0.58-1.01) in women (p for trend 0.05) and 0.81 (95% CI 0.63-1.03), 0.96 (95% CI 0.76-1.22) and 1.01 (95% CI 0.79-1.28) in men (p for trend 0.66) after adjustment for age, smoking, alcohol consumption, physical activity, systolic blood pressure, diabetes, use of blood pressure medication and body-mass index, with a significant gender × vitamin C interaction (p=0.03). Assuming a linear association, a 20 μmol/l increase in plasma vitamin C concentration (1 standard deviation) was associated with a 13% (95% CI 3-22%) relative reduction in risk of atrial fibrillation in women.
  
  
  CONCLUSIONS
  Plasma vitamin C was inversely associated with the risk of atrial fibrillation in women, but there was no such association in men. Our findings suggest that intake of food rich in vitamin C might be preventive for atrial fibrillation with a significant benefit particularly in women with low baseline intake.
authors.affiliation: Department III of Internal Medicine, Heart Centre of the University of Cologne, Cologne, Germany. Electronic address: roman.pfister@uk-koeln.de.
authors.forename: Roman
authors.initials: R
authors.lastname: Pfister
authors.affiliation: Department III of Internal Medicine, Heart Centre of the University of Cologne, Cologne, Germany. Electronic address: guido.michels@uk-koeln.de.
authors.forename: Guido
authors.initials: G
authors.lastname: Michels
authors.affiliation: Department III of Internal Medicine, Heart Centre of the University of Cologne, Cologne, Germany. Electronic address: Johannes.braegelmann@uk-koeln.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brägelmann
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. Electronic address: Stephen.Sharp@mrc-epid.cam.ac.uk.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Sharp
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom. Electronic address: robert.luben@phpc.cam.ac.uk.
authors.forename: Robert
authors.initials: R
authors.lastname: Luben
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. Electronic address: Nick.Wareham@mrc-epid.cam.ac.uk.
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Wareham
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom. Electronic address: kk101@medschl.cam.ac.uk.
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000097:blood*; D001281:Atrial Fibrillation / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001205:Ascorbic Acid
keywords: Atrial fibrillation; Fruit and vegetables; Plasma vitamin C