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Lipoprotein(a) Risk in Women and Efficacy of Ascorbate

Andrew G. Bostom, MD, MS
JAMA. 1994;272(15):1169. doi:10.1001/jama.1994.03520150035028.
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To the Editor.  —I would like to address two important issues raised by Gurewich and Mittleman1 in their Editorial on lipoprotein(a) [Lp(a)] levels and coronary heart disease in men: first, the lack of similar prospective data in women and, second, testing the hypothesis of Rath and Pauling2 that dietary supplementation with ascorbic acid might be efficacious in lowering elevated Lp(a) levels.My colleagues and I have reported that the presence of a sinking pre—β-lipoprotein band (a valid, specific marker for elevated Lp[a] levels3) is a strong, independent predictor of incident myocardial infarction, cerebrovascular disease, and intermittent claudication in Framingham women free of baseline cardiovascular disease.4 Also, in collaboration with investigators at Brown University, I recently completed a randomized, placebo-controlled intervention trial (A.G.B., unpublished data, 1994) testing one aspect of Rath and Pauling's hypothesis. In 44 subjects with documented coronary heart disease block, randomized (based on age,


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