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Previous Volume 334:1156-1162 May 2, 1996 Number 18 Next

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ABSTRACT

Background The role of dietary antioxidant vitamins in preventing coronary heart disease has aroused considerable interest because of the knowledge that oxidative modification of low-density lipoprotein may promote atherosclerosis.

Methods We studied 34,486 postmenopausal women with no cardiovascular disease who in early 1986 completed a questionnaire that assessed, among other factors, their intake of vitamins A, E, and C from food sources and supplements. During approximately seven years of follow-up (ending December 31, 1992), 242 of the women died of coronary heart disease.

Results In analyses adjusted for age and dietary energy intake, vitamin E consumption appeared to be inversely associated with the risk of death from coronary heart disease. This association was particularly striking in the subgroup of 21,809 women who did not consume vitamin supplements (relative risks from lowest to highest quintile of vitamin E intake, 1.0, 0.68, 0.71, 0.42, and 0.42; P for trend = 0.008). After adjustment for possible confounding variables, this inverse association remained (relative risks from lowest to highest quintile, 1.0, 0.70, 0.76, 0.32, and 0.38; P for trend = 0.004). There was little evidence that the intake of vitamin E from supplements was associated with a decreased risk of death from coronary heart disease, but the effects of high-dose supplementation and the duration of supplement use could not be definitively addressed. Intake of vitamins A and C did not appear to be associated with the risk of death from coronary heart disease.

Conclusions These results suggest that in postmenopausal women the intake of vitamin E from food is inversely associated with the risk of death from coronary heart disease and that such women can lower their risk without using vitamin supplements. By contrast, the intake of vitamins A and C was not associated with lower risks of dying from coronary disease.

Source Information

From the Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis (L.H.K., A.R.F., P.J.M.); the Department of Epidemiology and Public Health, University of Miami, Miami (R.J.P.); the Department of Epidemiology, University of Pittsburgh, Pittsburgh (Y.W.); and the Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, N.C. (R.M.B.).

Address reprint requests to Dr. Kushi at the Division of Epidemiology, University of Minnesota School of Public Health, 1300 S. Second St., Suite 300, Minneapolis, MN 55454-1015.

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N Engl J Med 1996; 335:1065-1069, Oct 3, 1996. Correspondence

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