Document Detail

High dose ascorbic acid does not reverse central sympathetic overactivity in chronic heart failure.
MedLine Citation:
PMID:  21916906     Owner:  NLM     Status:  MEDLINE    
WHAT IS KNOWN AND OBJECTIVE: The increased central sympathetic activity typically associated with chronic heart failure (CHF) is probably mediated by formation of reactive oxygen species (ROS) in the brain. Our objective was to undertake a trial to test our hypothesis that administration of the well-known antioxidant and ROS scavenger ascorbic acid, would reverse or reduce the sympathetic overactivity in CHF patients.
METHODS: In a prospective, randomized, placebo-controlled, double-blind, cross-over trial, 11 CHF patients were treated with ascorbic acid 2 g/day or placebo for 3 days. At the end of each treatment period, sympathetic nervous system activity was measured by microneurography for direct muscle sympathetic nerve activity (MSNA) recording, analysis of heart rate variability (HRV) and measurement of plasma norepinephrine concentrations.
RESULTS: During ascorbic acid administration, plasma vitamin C levels were higher than during placebo (74·9 ± 6·0 μmol/L vs. 54·8 ± 4·6 μmol/L, P = 0·03). Ascorbic acid had no effect on sympathetic activity: MSNA (ascorbic acid: 66·8 ± 3·3 vs. placebo 66·9 ± 3·2 bursts/100 beats, P = 0·98). In addition, HRV and plasma norepinephrine levels did not differ.
WHAT IS NEW AND CONCLUSION:   Short-term administration of the antioxidant ascorbic acid in CHF patients does not reverse the increased sympathetic activity as measured by microneurography, HRV and plasma norepinephrine levels. The use of higher oral dosages seems not feasible due to accompanying side effects.
M E Gomes; S El Messaoudi; J W M Lenders; L Bellersen; F W A Verheugt; P Smits; C J Tack
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-26
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  36     ISSN:  1365-2710     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-15     Completed Date:  2012-03-08     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  546-52     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Department of Internal Medicine Department of Cardiology Department of Pharmacology Toxicology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
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MeSH Terms
Ascorbic Acid / metabolism,  pharmacology*,  therapeutic use
Blood Pressure / physiology
Chronic Disease
Cross-Over Studies
Dose-Response Relationship, Drug
Double-Blind Method
Free Radical Scavengers / metabolism,  pharmacology*,  therapeutic use
Heart Failure / drug therapy*,  metabolism,  physiopathology
Heart Rate / physiology
Microelectrodes / utilization
Middle Aged
Muscles / innervation,  physiopathology
Norepinephrine / blood
Prospective Studies
Reactive Oxygen Species / metabolism
Sample Size
Sympathetic Nervous System / physiology,  physiopathology*
Grant Support
Reg. No./Substance:
0/Free Radical Scavengers; 0/Placebos; 0/Reactive Oxygen Species; 50-81-7/Ascorbic Acid; 51-41-2/Norepinephrine

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