Intended for healthcare professionals


Prospective cohort study of retinal vessel diameters and risk of hypertension

BMJ 2004; 329 doi: (Published 08 July 2004) Cite this as: BMJ 2004;329:79


As a contact lens pratitioner I was in the unique position in 1998 of
using the first of the electronic fundus cameras in a practice routinely
dispensing sodium ascorbate for (a) reduction of infection risk - mainly
Post- Adnoviral Keratitis (PVK) (b) allergy seen as Giant Papillary
Conjunctivitis (GPC) and (c) diabetic complications, all in a patient base
returning unusually except in contact lens practise, for 6 monthly eye
examinations. Diabetic need for extra vitamin C is little dealt with in
textbooks of management of diabetics (Cheraskin E - Vitamin C Who needs
it? Pub 1993.) (1)

Although the fundi were not imaged at every visit it had become
obvious from anterior segment examinations that scurvy (any state in which
supplemental vitamin C improves the pericorneal vasculature) was leading
to reductions of vessel lumen, congestion and hyperaemia in almost every
case. Microaneurysms and incipient microaneurysms were gradually
eliminated as dosages increased. It was judged that over 90% of patients
could be improved but some needed over 10,000mgs/day supplemented with
vitamin E. According to the received wisdom, the physicians consulted by
these patients continued to doubt the necessity for such large doses and a
degree of friction existed.

Serendipitously, two years later, when comparing optic disc images
to detect primary open angle glaucoma (POAG) in the procedure I had
earlier named Sequential Photometric Overlays Alerting Glaucoma (SPOAG)in
'Optometry Today'it was noticed that those patients taking supplemental
ascorbate were showing reductions of retinal arterial cholesterol,
typically seen at stressed points e.g. bifurcations.

CardioRetinometry appears to confirm the original work by Paterson
(1939/40) and later, Willis & Fishman (1955)(2-8) – all naming low
Vitamin C as being associated with death from Coronary Heart Disease
(CHD). Pauling/Rath theory (Lipoprotein alpha is a surrogate for vitamin
C) appears also to be well confirmed (9-14)

It was decided to research this and a company was formed
(AntiCoronary Clinics (UK) Ltd) both to explore the possibilities of a
study aided by local physicians and to determine if it could be
financially viable as no grant could be anticipated from competing sources
of funding especially as the method apppeared to have advantages over
electron beam tomography (EBT) and angiography. The method appeared to be
demonstrating more atheroma than EBT and it is confidently anticipated
that CardioRetinometry will prove to be a better surrogate outcome
predictor of reduced CHD risk than any current diagnostic procedure.

CardioRetinometry has already also demonstrated reductions of
cholesterol in the retinal venules and it is believed by the author that
cholesterol in the firt post capillary venules and veins, deposited
against the current received wisdom, is the precursor of arterioscleosis
and essential hypertension.

A research grant application is now in the pipeline.

Sydney J Bush
PhD. DOpt. (IOSc London)

References and End Notes:

1.) Cheraskin E MD. DMD. - Vitamin C Who needs it? Pub Arlington 1993.
Five textbooks on diabetic management fail to mention vitamin C.p98.

2.) J. C. Paterson (1939 - 1940) CAPILLARY RUPTURE WITH 2. INTIMAL

3.) J. C. Paterson (1940) Arch Path, Vol 29, 1940, Pg 345-354 : SOME

4.) J. C. Paterson (1941) Canad. M. A. J., Feb 1941, Pg 114-120

5.) G.C. Willis, An Experimental Stdy of the Intimal Ground Substance in
Atherosclerosis, Canad. M. A. J. Vol 69, 1953, p. 17-22

6.) G. C. Willis, A. W. Light, W.S. Cow, Serial Arteriography in
Atherosclerosis Canad. M. A. J. Dec 1954, Vol 71, 1954, p. 562-568

7.) G. C. Willis, S. Fishman, Ascorbic Acid Content of Human Arterial
Tissue. Canad. M. A. J., April 1, 1955, Vol 72, Pg 500-503

8.) G.C. Willis, The Reversibility of Atherosclerosis, Canad. M. A. J.,
July 15, 1957, Vol 77., Pg 106-109

9.) Pauling L. Rath M. Hypothesis: Lipoprotein(a) is a surrogate for
ascorbate.Proc Natl Acad Sci U S A. 1990 Aug;87(16):6204-7Linus Pauling
Institute of Science and Medicine, Palo Alto, CA 94306.
Cardiologist Matthias Rath. M.D.) Joint worker with Linus Pauling co-
writer of Unified Theory of Human Cardiovascular Disease Leading the Way
to the Abolition of This Disease as a Cause of Human Mortality. J. of
Orthomolecular Medicine 7:5-15 (1992a)

10.)Rath M. Pauling L. Solution to the Puzzle of Human Cardiovascular
Disease: Its Primary Cause is Ascorbate Deficiency Leading to the
Deposition of Lipoprotein Alpha and Fibrinogen/Fibrin in the Vascular
Wall. J. of Orthomolecular Medicine 6:125-34(1991a)

10.) Rath M. Pauling L. Apoprotein(a) is an Adhesive Protein. J. of
Orthomolecular Medicine 6:139-43(1991b)

11.) Rath M. Pailing L. Plasma Induced Proteolysis and the Role of
Lipoprotein alpha, Lysine and Synthetic Lysine Analogues J. of
Orthomolecular Medicine 7:17-23(1992b)

12.) Rath M. Lipoprotein alpha Reduction by Ascorbate. J. of
Orthomolecular Medicine 7:81-82(1992c)

13.) Rath M. Reducing the Risk of Cardiovascular Disease with Nutritional
Supplements. J. of Orthomolecular Medicine 7:153-62(1992e)

14.) Rath M. Cationic-anionic and Anionic-cationic Oligopeptides in
Apoprotein(a) and Other Proteins as Modulators of Protein Action and of
Biological Communication. J. of Applied Nutrition 44:62-9(1992f)

Competing interests:
AntiCoronary Clinics (UK) Ltd. 20-22 Brook St. Hull HU2 8LA

Competing interests: No competing interests

23 July 2004
Sydney J Bush
Optometrist. CardioRetinometrist
20-22 Brook St. HULL HU2 8LA