Low β-carotene concentrations increase the risk of cardiovascular disease mortality among Finnish men with risk factors

Background & aims: 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. Methods & 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, alpha-carotene and beta-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 beta-carotene were strongly related to an increased CVD mortality risk after adjustment for confounders. For beta-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 beta-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 beta-carotene concentrations may increase the risk for CVD mortality among Eastern Finnish men; thus elevated serum concentrations of beta-carotene may have clinical and public health relevance. (C) 2012 Elsevier B. V. All rights reserved.