Lipoprotein(a) Risk in Women and Efficacy of Ascorbate

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investigators at Brown University, I recently completed a randomized, placebo-controlled intervention trial (A.G.B., unpublished data, 1994) testing one aspect of Rath and Pauling's hypothesis.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,