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Vitamin E Consumption and the risk of coronary heart disease in men20.05.1993 | The New England Journal of Medicine
Vitamin E Consumption and the risk of coronary heart disease in men
Vitamin E Consumption and the risk of coronary heart disease in men - Rimm NEJM 1993 - Abstract The New England Journal of Medicine
The New England Journal of Medicine -- May 20, 1993 -- Vol. 328, No. 20
Eric B. Rimm, Meir J. Stampfer, Alberto Ascherio, Edward Giovannucci, Graham A. Colditz, Walter C. Willett
Background. The oxidative modification of low-density lipoproteins increases their incorporation into the arterial intima, an essential step in atherogenesis. Although dietary antioxidants, such as vitamin C, carotene, and vitamin E, have been hypothesized to prevent coronary heart disease, prospective epidemiologic data are sparse.
Methods. In 1986, 39,910 U.S. male health professionals 40 to 75 years of age who were free of diagnosed coronary heart disease, diabetes, and hypercholesterolemia completed detailed dietary questionnaires that assessed their usual intake of vitamin C, carotene, and vitamin E in addition to other nutrients. During four years of follow-up, we documented 667 cases of coronary disease.
Results. After controlling for age and several coronary risk factors, we observed a lower risk of coronary disease among men with higher intakes of vitamin E (P for trend = 0.003). For men consuming more than 60 IU per day of vitamin E, the multivariate relative risk was 0.64 (95 percent confidence interval, 0.49 to 0.83) as compared with those consuming less than 7.5 IU per day. As compared with men who did not take vitamin E supplements, men who took at least 100 IU per day for at least two years had a multivariate relative risk of coronary disease of 0.63 (95 percent confidence interval, 0.47 to 0.84). Carotene intake was not associated with a lower risk of coronary disease among those who had never smoked, but it was inversely associated with the risk among current smokers (relative risk, 0.30; 95 percent confidence interval, 0.11 to 0.82) and former smokers (relative risk, 0.60; 95 percent confidence interval, 0.38 to 0.94). In contrast, a high intake of vitamin C was not associated with a lower risk of coronary disease.
Conclusions. These data do not prove a causal relation, but they provide evidence of an association between a high intake of vitamin E and a lower risk of coronary heart disease in men. Public policy recommendations with regard to the use of vitamin E supplements should await the results of additional studies. (N Engl J Med 1993;328:1450-6.)
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. Supported by research grants (HL 35464 and CA 55075) from the National Institutes of Health.