Listed in Issue 28


EMMERT and KIRCHNER, Department of Family and Community Medicine, Lancaster General Hospital, PA USA. write that data from the 1970s first suggested that vitamin E may be effective in reducing mortality from cardiovascular disease. The authors review (39 references) the evidence.




As the understanding of the antioxidant effect of vitamin E evolved, researchers further studied the biological effects of vitamin E. In vitro research has shown vitamin E to have several potentially cardioprotective effects. These include the antagonism of the oxidation of low-density lipoproteins, which inhibit platelet aggregation and adhesion, prevent smooth muscle proliferation and preserve normal coronary dilation. Several prospective research studies, including the US Nurses Health Study and the US Health Professionals Follow-up Study, demonstrated a 34% and 39% reduction respectively, in the risk of a cardiac event for the people taking vitamin E supplements. The Iowa Womens Health Study demonstrated a 47% reduction in cardiac mortality. Results of randomised, controlled clinical trials have not always found consistent benefit, the best known being the Cambridge Heart Antioxidant study, which found a 47% reduction in fatal and nonfatal myocardial infarction in patients with proven coronary atherosclerosis given 400 or 800 IU of vitamin E per day. There was, however, no effect upon mortality.


Emerging and promising data suggest the potential benefit of vitamin E for high-risk cardiac patients. Physicians should carefully monitor the results of randomised controlled clinical trials already in progress.


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