Cardiovascular disease not prevented by supplementation with vitamins e or c

Cardiovascular disease not prevented by supplementation with vitamins e or c

The risk of cardiovascular events is not reduced by vitamin E or vitamin C supplements, as determined in a large, long-term randomized study of male physicians, according to an article released on November 9, 2008 in JAMA to coincide with the scientific presentation of these findings at the current American Heart Association (AHA) meeting.

Vitamin supplements are a common form of medication in the United States, and according to background information in the article, most adults here have taken them in the last year. There has been previous research into the roles played by vitamin E and vitamin C in heart disease. "Basic research studies suggest that vitamin E, vitamin C, and other antioxidants reduce cardiovascular disease by trapping organic free radicals, by deactivating excited oxygen molecules, or both, to prevent tissue damage." Previous observational studies have indicated that both vitamin E and vitamin C were related to various cardiovascular disease prevention.

In the Physicians' Health Study II, Howard D. Sesso, Sc.D, M.P.H., and colleagues from Brigham and Women's Hospital, Harvard Medical School and School of Public Health and VA Boston Healthcare System, Boston, 14,641 male physicians were evaluated for the effects of vitamin E and vitamin C supplements on cardiovascular event incidence. A the inception of the study in 1997, the subjects were 50 years or older, and at low risk for cardiovascular disease. Of the total, 5.1% (754) physicians had cardiovascular disease. Each subject was randomized to recieve 400IU of vitamin E every other day or a placebo; each patient was also randomized to receive 500mg of vitamin C daily or a placebo.

The subjects were followed up for an average of 8 years, during which there were 1,245 confirmed major cardiovascular events. Of these, 511 heart attacks (myocardial infarctions), 464 strokes, and 509 cardiovascular deaths were experienced -- with some men experiencing more than one event. During the follow up period, 1,661 men died.

When comparing the supplemented groups to the placebo, neither vitamin E nor vitamin C had any effects on cardiovascular event incidence. The authors also note: "Neither vitamin E nor vitamin C had a significant effect on total mortality, but vitamin E was associated with an increased risk of hemorrhagic stroke."

The authors conclude that vitamin E and vitamin C supplementation should not be indicated for prevention of cardiovascular disease in this group. "In this large, long-term trial of male physicians, neither vitamin E nor vitamin C supplementation reduced the risk of major cardiovascular events. These data provide no support for the use of these supplements for the prevention of cardiovascular disease in middle-aged and older men," they write.

Vitamins E and C in the Prevention of Cardiovascular Disease in Men: The Physicians' Health Study II Randomized Controlled Trial

Howard D. Sesso; Julie E. Buring; William G. Christen; Tobias Kurth; Charlene Belanger; Jean MacFadyen; Vadim Bubes; JoAnn E. Manson; Robert J. Glynn; J. Michael Gaziano

JAMA. 2008;300(18):2123-2133.

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