Background Interest in the antioxidant vitamin E as a possibleprotective nutrient against coronary disease has intensifiedwith the recognition that oxidized low-density lipoprotein maybe involved in atherogenesis.
Methods In 1980, 87,245 female nurses 34 to 59 years of agewho were free of diagnosed cardiovascular disease and cancercompleted dietary questionnaires that assessed their consumptionof a wide range of nutrients, including vitamin E. During follow-upof up to eight years (679,485 person-years) that was 97 percentcomplete, we documented 552 cases of major coronary disease(437 nonfatal myocardial infarctions and 115 deaths due to coronarydisease).
Results As compared with women in the lowest fifth of the cohortwith respect to vitamin E intake, those in the top fifth hada relative risk of major coronary disease of 0.66 (95 percentconfidence interval, 0.50 to 0.87) after adjustment for ageand smoking. Further adjustment for a variety of other coronaryrisk factors and nutrients, including other antioxidants, hadlittle effect on the results. Most of the variability in intakeand reduction in risk was attributable to vitamin E consumedas supplements. Women who took vitamin E supplements for shortperiods had little apparent benefit, but those who took themfor more than two years had a relative risk of major coronarydisease of 0.59 (95 percent confidence interval, 0.38 to 0.91)after adjustment for age, smoking status, risk factors for coronarydisease, and use of other antioxidant nutrients (including multivitamins).
Conclusions Although these prospective data do not prove a cause-and-effectrelation, they suggest that among middle-aged women the useof vitamin E supplements is associated with a reduced risk ofcoronary heart disease. Randomized trials of vitamin E in theprimary and secondary prevention of coronary disease are beingconducted; public policy recommendations about the widespreaduse of vitamin E should await the results of these trials.
Source Information
From the Channing Laboratory and the Division of Preventive Medicine, Department of Medicine (M.J.S., C.H.H., J.E.M., G.A.C., B.R., W.C.W.), Harvard Medical School and Brigham and Women's Hospital; and the Departments of Epidemiology (M.J.S., G.A.C., W.C.W.), Biostatistics (B.R.), and Nutrition (W.C.W.), Harvard School of Public Health -- all in Boston.
Address reprint requests to Dr. Stampfer at the Channing Laboratory, 180 Longwood Ave., Boston, MA 02115.
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