Letter: Vitamin C in Heart Failure: Hype or Hope?

To the Editor: Free radical-mediated oxidative processes are believed to play a key role in the pathogenesis of many cardiovascular disorders, including congestive heart failure.1 Consequently, a large number of mechanistic studies have investigated the potential benefits of antioxidant treatment. In NHANES 1, individuals reporting a high dietary intake of antioxidants (including vitamin C [VC]) had a significantly lower death rate from all causes, especially coronary heart disease.2 However, subsequent prospective, randomized clinical trials in high-risk populations failed to confer a benefit.3 In this light, we read with great interest the article by Piccirillo et al4 demonstrating that a short (presumably intravenous) infusion of 2.5 g VC (as corrected by the authors) improved baroreflex sensitivity (BRS) and vagal sinus modulation in patients with congestive heart failure. The former finding largely confirms our own recent work, showing that acute administration of 2 g VC (raising plasma levels from 60.2±30.1 to 786±415.3 μmol/L; P <0.001) improves …