The study included 1,395 participants in the National Health and Nutrition Examination Survey (2001-2010) who had cardiovascular disease, which included coronary heart disease, congestive heart failure, heart attack, stroke or angina at the beginning of the study. Dietary recall interview responses were analyzed for the intake of vitamins A, C and E, carotenoids, selenium and zinc, and composite dietary antioxidant indexes (CDAI) were calculated. Authors Xintao Hu and colleagues explained that CDAI “takes into account the contribution of various antioxidants to the body’s antioxidant capacity.”
Six hundred eighty-two deaths occurred through 2019. Having an intake of vitamin C that was among the highest one-third of individuals in the study was associated with an adjusted 27% lower risk of death from all causes during follow-up in comparison with the risk associated with vitamin C intake that was among the lowest third. For vitamin E, those whose intake was among the top third had a 32% lower risk of mortality compared with the lowest third. Carotenoids were also protective, with an adjusted 22% lower risk of mortality experienced by individuals whose intake was among the highest. When composite dietary antioxidant index was evaluated, men and women among the top third had a 38% lower risk of mortality during follow-up.
Evaluation of the effects of antioxidants on the risk of dying from cardiovascular disease revealed that high intake of vitamin E and zinc was associated with respective 41% and 36% lower risks, and a high CDAI was associated with a 42% lower risk.
“Higher levels of dietary antioxidants are associated with a reduced risk of both all-cause and cardiovascular-cause mortality in patients with cardiovascular disease,” the authors concluded. “These findings suggest that increasing antioxidant intake may serve as a potential strategy for improving outcomes in this population.”
The study was reported April 9, 2025, in BMC Public Health.1
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