Preventing Plaque Buildup: The Role of Vitamin C in Cardiovascular Disease

Almost eighteen million people across the globe die from cardiovascular disease every year and the numbers are rising. Cardiovascular disease is a disorder of the heart and blood vessels. It develops when plaque builds up in the walls of arteries, a phenomenon known as atherosclerosis.

Here’s where it gets frightening. If the plaque ruptures and forms a clot, it can trigger a heart attack or stroke. This clot prevents the blood flow to areas of the heart or the brain and consequently causes death to portions of the tissues that the artery delivers blood to. That’s why prevention is so important.

How well do you know your family history? Did any of your close relatives have a heart attack or stroke before 50? Then you may be at higher risk yourself. There’s a genetic component to cardiovascular disease, but lifestyle and dietary habits influence your risk of heart attack or stroke, too.

In fact, research shows that lifestyle can offset the genetic risks you might face. This includes controlling high blood pressure, lipids, elevated blood sugar, kicking the smoking habit, and staying active.

Vitamin C, Diet, and Cardiovascular Disease

But what about your diet? You know the mantra: Eat whole foods, limit the amount of sugar in your diet, and choose more fiber-rich foods. But what role do specific nutrients play in heart and blood vessel health?

One nutrient that’s garnered attention for preventing cardiovascular disease is vitamin C, a vitamin you need for a healthy immune system, collagen, and wound healing. But it’s the antioxidant activity of vitamin C that could help keep your heart and blood vessels healthy. Vitamin C helps tackle those annoying free radicals that damage tissues and trigger inflammation, the type that places you at higher risk of heart attacks and strokes. Could consuming enough vitamin C lower your risk?

The Antioxidant Effects of Vitamin C for Heart Health

Studies show the main way vitamin C benefits heart and blood vessel health is via its antioxidant properties. Vitamin C is a powerful free radical scavenger. This means it helps neutralize free radicals that damage cells and tissues. If you’re producing a lot of free radicals, it can oxidize LDL-cholesterol, a major step in damaging the interior walls of your arteries, leading to atherosclerosis. The good news? Vitamin C can sweep in and scavenge free radicals, so they don’t oxidize LDL-cholesterol.

But vitamin C does even more than that. It increases the amount of nitric oxide that the inner walls of your blood vessels produce. How does it do this? It boosts the activity of an enzyme called nitric oxide synthase that increases the amount of nitric oxide your blood vessels have access to. Scientists refer to the blood vessel benefits you get from nitric oxide (wider blood vessels) as improved endothelial function.)

When you have better endothelial function your blood vessels respond better to stress. Your blood pressure drops and you’re at a lower risk of blood clots. Nitric oxide is a key component of healthy endothelial function, as it reduces the odds of platelets clumping together to form a clot. A study published in the Journal of Cardiovascular Pharmacology found that supplementing with vitamin C improved endothelial function in patients with hypercholesterolemia, a common condition marked by high levels of LDL cholesterol.

Do Scientific Studies Support These Benefits?

The highest quality studies are randomized controlled trials, so those are the trials that carry the most weight. One analysis of forty-four randomized controlled studies found that supplementing with vitamin C lowered the risk of developing cardiovascular disease by 25%. Another study showed that taking vitamin C supplements improved markers of heart health, including blood pressure and blood lipids in people with type 2 diabetes.

Should You Take a Vitamin C Supplement?

Plant-based foods contain substantial amounts of vitamin C, so you may be able to get enough vitamin C for a healthy heart and blood vessels through diet. But keep in mind that heat damages vitamin C, so it’s a good idea to eat raw fruits and vegetables too. The recommended daily intake of vitamin C is:

Men: 90 mg
Women: 75 mg

However, studies suggest that we may get more cardiovascular benefits by consuming slightly more – 80 mg. to 110 mg. of vitamin C each day. But you don’t need megadoses. Research shows the receptors for vitamin C become saturated beyond 200 mg. of vitamin C per day.

Getting enough heart-healthy vitamin C is easy if you consume some of the highest vitamin C foods. These include:

Acerola Cherries: Half a cup (49 grams) of red acerola cherries provides 916% of the DV for vitamin C, making them an excellent source.
Rose Hips: Rose hips contain 426 mg of vitamin C per one hundred grams and can promote healthier-looking skin. About six pieces of this fruit deliver 132% of the DV.
Green Chili Peppers: One green chili pepper contains 242 mg of vitamin C per one hundred grams, delivering 121% of the DV.
Guavas: Guavas contain 228 mg of vitamin C per one hundred grams, with one guava delivering 138% of the DV.
Strawberries: Strawberries contain 59 mg of vitamin C per one hundred grams, with one cup of strawberry slices delivering 97 mg of vitamin C.
Oranges: Oranges contain 59 mg of vitamin C per one hundred grams, with one medium orange delivering 83 mg of vitamin C.

Based on the available evidence, here are guidelines:

Eat a variety of fruits and vegetables, both cooked and raw.
If you’re at elevated risk of cardiovascular disease, ensure you’re getting enough vitamin C. If you don’t eat many plant-based foods, talk to your doctor about whether you would benefit from a vitamin C supplement.
If you take a vitamin C supplement, consider a liposomal form of vitamin C. This type of vitamin C is enclosed in a fatty layer that boosts absorption and protects vitamin C as it moves through your digestive system.
Since vitamin C dissolves in water, you absorb it best on an empty stomach. If you take a supplement, take it an hour before a meal or 3 hours afterward.
Taking too much vitamin C in supplement form can cause side effects, including digestive upset. Sources recommend not exceeding one thousand milligrams of vitamin C daily and most people don’t need that amount. If you have a history of calcium oxalate kidney stones, taking copious quantities of vitamin C increases your risk of stones.

Conclusion

Research suggests that consuming enough vitamin C, and a little above the current recommendations, may lower your risk of heart attack and stroke. Yet, it’s not clear what the ideal dose for getting the full benefits is. The best approach is adding more vitamin C rich foods to your plate.

References:

May JM, Harrison FE. Role of vitamin C in the function of the vascular endothelium. Antioxid Redox Signal. 2013 Dec 10;19(17):2068-83. doi: 10.1089/ars.2013.5205. Epub 2013 May 29. PMID: 23581713; PMCID: PMC3869438.
Morelli MB, Gambardella J, Castellanos V, Trimarco V, Santulli G. Vitamin C and Cardiovascular Disease: An Update. Antioxidants (Basel). 2020 Dec 3;9(12):1227. doi: 10.3390/antiox9121227. PMID: 33287462; PMCID: PMC7761826.
Lynch SM, Gaziano JM, Frei B. Ascorbic acid, and atherosclerotic cardiovascular disease. Subcell Biochem. 1996;25:331-67. doi: 10.1007/978-1-4613-0325-1_17. PMID: 8821982.
Vitamin C (Ascorbic acid) Information | Mount Sinai – New York. Mount Sinai Health System. Published 2024. Accessed August 4, 2024. https://www.mountsinai.org/health-library/supplement/vitamin-c-ascorbic-acid

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