1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

Vitamins C and E in Cardiovascular Disease Prevention

These vitamins provide no CVD benefit in low-risk men.

Despite biological plausibility for the antioxidant effects of vitamins C and E in preventing cardiovascular disease (CVD), results from observational and randomized studies have ranged from mixed to mostly negative. In a randomized, controlled trial, 14,641 male physicians (mean age, 64) received daily vitamin E (400 IU), vitamin C (500 mg), both, or neither.

The men were at relatively low risk, but some had prior myocardial infarction (5%) or known hypertension (42%), dyslipidemia (37%), or diabetes (6%). During a mean follow-up of 8 years, 1245 cardiovascular events occurred — roughly 11 per 1000 person-years. Using a composite endpoint that included both fatal and nonfatal cardio- and cerebrovascular disease, researchers found no differences in outcomes among the four groups. The results did not change when stratified for previous CVD or other risk factors. A near doubling in risk for hemorrhagic stroke was observed in the vitamin E groups, although the change in absolute risk was small (39 vs. 23 events).

Comment: These data add to those from previous trials that showed no cardiovascular benefit from supplementation with vitamins E or C, and this study raises the possibility of excess risk for hemorrhagic stroke with vitamin E. No basis exists for supplementation with these vitamins in usual care of middle-aged or older men.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine November 13, 2008

Citation(s):

Sesso HD et al. Vitamins E and C in the prevention of cardiovascular disease in men: The Physicians’ Health Study II randomized controlled trial. JAMA 2008 Nov 12; 300:2123.

• Original article (Subscription may be required)
• Medline abstract (Free)