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VITAMIN E MAY REDUCE CORONARY RISK IN MEN AND WOMEN.

In vitro studies suggest that antioxidant vitamins can impede atherosclerosis. Two large observational studies indicate that the same may be true in vivo.

The prospective Nurses' Health Study followed 87,245 women aged 34 to 59 without known coronary disease. After adjustment for age and smoking, the risk for major coronary disease (nonfatal MI or death from coronary disease) was 0.66 in women with the highest average intake of vitamin E (208 IU/day) relative to women with the lowest intake (below 3 IU/day). Results were similar after adjustment for other coronary risk factors and the use of other antioxidant vitamins.

The benefits were strongest for women who took vitamin E supplements (100 IU/day) for more than 2 years. Shorter-term use yielded no significant risk reduction, and dietary vitamin E reduced risk only slightly. Cardiovascular and overall mortality were also lower for supplement users (RRs, 0.58 and 0.87), but the differences were nonsignificant.

The Health Professionals Follow-up Study followed 39,910 men aged 40 to 75. After controlling for age, coronary risk factors, and multivitamin use, men who took at least 100 IU of vitamin E daily for at least 2 years had a risk of 0.63 for major coronary disease relative to nonusers. Men taking the most vitamin E also had a marginally significant reduction in overall mortality (RR, 0.78). Men who took the most beta-carotene (over 19,000 IU/day) had a risk of 0.72 for coronary disease relative to those with the lowest intakes. Vitamin C supplementation was not associated with reduced coronary risk.

These careful nonrandomized studies suggest that lipid- soluble antioxidant vitamins reduce the risk for coronary disease when taken as supplements. An editorialist argues against promoting use of vitamin E and beta-carotene until randomized trials now under way are completed.

— ALK

Published in Journal Watch General Medicine May 28, 1993

Citation(s):

Steinberg D. Antioxidant vitamins and coronary heart disease. N Engl J Med 1993 May 20 328 1487-1489.

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Rimm EB et al. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 1993 May 20 328 1450-1456.

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Stampfer MJ et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993 May 20 328 1444-1449.

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• Medline abstract (Free)