Dietary Antioxidants and Cardiovascular Health: Insights from a 14-Year UK Biobank Trajectory Analysis

Abstract

Background:

To evaluate the impact of the composite dietary antioxidant index (CDAI) on the progression from hypertension (HT) to cardiovascular diseases (CVDs) and subsequent death.

Methods:

This prospective study included 100,193 participants (median age 55) initially free of HT and CVDs from the UK Biobank. The CDAI was calculated from the intake of six dietary antioxidants, including manganese, selenium, zinc, and vitamins A, C, and E. Multivariable Cox regression analysis assessed the relationship between CDAI and the risks of HT, CVDs, and all-cause mortality. Multistate models were used to examine the impact of CDAI levels on CVD progression trajectories.

Results:

During a median follow-up of 14.10 years, 11,998 participants developed HT, 3656 developed CVDs, and 4169 died. CDAI was inversely associated with the risk of adverse outcomes, including HT, CVDs, and death. Compared with the lowest CDAI quartile, the adjusted hazard ratios (HRs; confidence intervals [CIs]) for the highest quartile in transitions from baseline to HT, to CVDs, and to death were 0.913 (0.868–0.960), 0.890 (0.799–0.992), and 0.850 (0.767–0.942), respectively. An association between the highest quartile CDAI and reduced risk was also observed in transitions from HT to CVDs (HR: 0.698; 95% CI: 0.558–0.872) and from HT to death (HR: 0.803; 95% CI: 0.648–0.995). Mediation analysis indicates that the reduction in CVD and mortality risk associated with CDAI primarily depends on its direct effect rather than its indirect effect through HT.

Conclusions:

The CDAI influences the progression of CVD trajectories, underscoring the need for dietary adjustments to elevate CDAI levels in CVD health management. Antioxid. Redox Signal. 44, 712–725.