Background The oxidative modification of low-density lipoproteinsincreases their incorporation into the arterial intima, an essentialstep in atherogenesis. Although dietary antioxidants, such asvitamin C, carotene, and vitamin E, have been hypothesized toprevent coronary heart disease, prospective epidemiologic dataare sparse.
Methods In 1986, 39,910 U.S. male health professionals 40 to75 years of age who were free of diagnosed coronary heart disease,diabetes, and hypercholesterolemia completed detailed dietaryquestionnaires that assessed their usual intake of vitamin C,carotene, and vitamin E in addition to other nutrients. Duringfour years of follow-up, we documented 667 cases of coronarydisease.
Results After controlling for age and several coronary riskfactors, we observed a lower risk of coronary disease amongmen with higher intakes of vitamin E (P for trend = 0.003).For men consuming more than 60 IU per day of vitamin E, themultivariate relative risk was 0.64 (95 percent confidence interval,0.49 to 0.83) as compared with those consuming less than 7.5IU per day. As compared with men who did not take vitamin Esupplements, men who took at least 100 IU per day for at leasttwo years had a multivariate relative risk of coronary diseaseof 0.63 (95 percent confidence interval, 0.47 to 0.84). Caroteneintake was not associated with a lower risk of coronary diseaseamong those who had never smoked, but it was inversely associatedwith the risk among current smokers (relative risk, 0.30; 95percent confidence interval, 0.11 to 0.82) and former smokers(relative risk, 0.60; 95 percent confidence interval, 0.38 to0.94). In contrast, a high intake of vitamin C was not associatedwith a lower risk of coronary disease.
Conclusions These data do not prove a causal relation, but theyprovide evidence of an association between a high intake ofvitamin E and a lower risk of coronary heart disease in men.Public policy recommendations with regard to the use of vitaminE supplements should await the results of additional studies.
Source Information
From the Departments of Epidemiology (E.B.R., M.J.S., A.A., G.A.C., W.C.W.) and Nutrition (A.A., W.C.W.), Harvard School of Public Health; and the Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital (M.J.S., E.G., G.A.C., W.C.W.) -- all in Boston.
Address reprint requests to Dr. Rimm at the Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115.
Vitamin E and the Risk of Coronary Disease
O'Keefe J. H., Lavie C. J., Steiner M., Powell L. H., Black H. R., Sullivan J. L., Stampfer M. J., Rimm E. B., Willett W. C., Steinberg D.
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N Engl J Med 1993;
329:1424-1426, Nov 4, 1993.
Correspondence
Beta Carotene, Vitamin E, and Lung Cancer
Marantz P. R., Kritchevsky D., Goldstein M. R., Pryor W. A., Leo M. A., Lieber C. S., Ballmer P. E., Stahelin H. B., Heinonen O. P., Huttunen J. K., Albanes D., Taylor P. R., The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group , Hennekens C. H., Buring J. E., Peto R.
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N Engl J Med 1994;
331:611-614, Sep 1, 1994.
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