Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer: The Women’s Health Study: A Randomized Controlled Trial

Department of Biomedical Science, Florida Atlantic University, Boca Raton, Florida, United States
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 08/2005; 294(1):56-65. DOI: 10.1001/jama.294.1.56
Source: PubMed


Basic research provides plausible mechanisms and observational studies suggest that apparently healthy persons, who self-select for high intakes of vitamin E through diet or supplements, have decreased risks of cardiovascular disease and cancer. Randomized trials do not generally support benefits of vitamin E, but there are few trials of long duration among initially healthy persons.
To test whether vitamin E supplementation decreases risks of cardiovascular disease and cancer among healthy women.
In the Women's Health Study conducted between 1992 and 2004, 39 876 apparently healthy US women aged at least 45 years were randomly assigned to receive vitamin E or placebo and aspirin or placebo, using a 2 x 2 factorial design, and were followed up for an average of 10.1 years.
Administration of 600 IU of natural-source vitamin E on alternate days.
Primary outcomes were a composite end point of first major cardiovascular event (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) and total invasive cancer.
During follow-up, there were 482 major cardiovascular events in the vitamin E group and 517 in the placebo group, a nonsignificant 7% risk reduction (relative risk [RR], 0.93; 95% confidence interval [CI], 0.82-1.05; P = .26). There were no significant effects on the incidences of myocardial infarction (RR, 1.01; 95% CI, 0.82-1.23; P = .96) or stroke (RR, 0.98; 95% CI, 0.82-1.17; P = .82), as well as ischemic or hemorrhagic stroke. For cardiovascular death, there was a significant 24% reduction (RR, 0.76; 95% CI, 0.59-0.98; P = .03). There was no significant effect on the incidences of total cancer (1437 cases in the vitamin E group and 1428 in the placebo group; RR, 1.01; 95% CI, 0.94-1.08; P = .87) or breast (RR, 1.00; 95% CI, 0.90-1.12; P = .95), lung (RR, 1.09; 95% CI, 0.83-1.44; P = .52), or colon cancers (RR, 1.00; 95% CI, 0.77-1.31; P = .99). Cancer deaths also did not differ significantly between groups. There was no significant effect of vitamin E on total mortality (636 in the vitamin E group and 615 in the placebo group; RR, 1.04; 95% CI, 0.93-1.16; P = .53).
The data from this large trial indicated that 600 IU of natural-source vitamin E taken every other day provided no overall benefit for major cardiovascular events or cancer, did not affect total mortality, and decreased cardiovascular mortality in healthy women. These data do not support recommending vitamin E supplementation for cardiovascular disease or cancer prevention among healthy women.

1 Follower
18 Reads
  • Source
    • "R em esy, 2005; Velayutham, Babu, & LiuCurr, 2008). Various studies show a relationship between a vitamin or polyphenolic rich diet and reduced risk of coronary heart disease, diabetes, cancer, and even higher life expectancy (Knekt et al., 2002; Lee et al., 2005; Rimm et al., 1993). Thus nutrition could be a preventive strategy in order to reduce oxidative damage and its associated pathologies. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Fruit and vegetables are believed to help fight against oxidative stress, given their natural content in radical scavenging compounds. Natural polyphenols neutralize reactive oxygen species by means of electron and hydrogen atom transfers. An HPLC method, hyphenated with a post-column reaction system relying on ABTS+ bleaching assay was applied in order to quantify the chemical activity of radical scavenging compounds in red cabbage, onion, quince, sweet cherry, strawberry, carrot and tomato. Hyphenated to the ABTS+ post-column reaction system, this method showed high antioxidant capacity notably in cherry, quince, onion, or red cabbage. Structural analysis of the compounds of interest showed the implication of several cyanidins and caffeoylquinic acids in cherry. Quince and red cabbage were found highly active through the presence of respectively caffeoylquinic acids, and an important content of diverse cyanidins variously glycosylated and acylated. The onion extract revealed a chemical core structure (quercetin) responsible for its antioxidant capacity. Moreover, our results showed that depending on the glycosylation profile of these compounds, their radical scavenging capacity can be very different.
    Lebensmittel-Wissenschaft und-Technologie 06/2015; 62(1). DOI:10.1016/j.lwt.2015.01.004 · 2.42 Impact Factor
    • "Many scientific reports have suggested that the intake of antioxidant compounds is an efficient way of combating undesired health risks associated with the presence of reactive oxygen species such as cardiovascular and neurodegenerative diseases, cancer, atherosclerosis, diabetes, etc [1] [2] [3]. For this reason, antioxidant-rich foods have gain considerable popularity and a variety of methods have been developed that can account for the antioxidant properties of natural products [4] [5] [6] [7] [8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: With the increasing interest in the health benefits arising from the consumption of dietary products rich in antioxidants, there exists a clear demand for easy-to-use and cost-effective tests that can be used for the identification of the antioxidant power of food products. Paper-based analytical devices constitute a remarkable platform for such expedient and low-cost assays with minimal external resources but efforts in this direction are still scarce. In this work we introduce a new paper-based device in the form of a sensor patch that enables the determination of antioxidant activity through analyte-driven on-paper formation of gold nanoparticles. The principle of detection capitalizes, for the first time, on the on-paper nucleation of gold ions to its respective nanoparticles, upon reduction by antioxidant compounds present in an aqueous sample. The ensuing chromatic transitions, induced on the paper surface, are used as an optical "signature" of the antioxidant strength of the solution. The response of the paper-based sensor was evaluated against a large variety of antioxidant species and the respective dose response curves were constructed. On the basis of these data, the contribution of each species according to its chemical structure was elucidated. For the analysis of real samples, a concentration-dependent colorimetric response was established against Gallic acid equivalents over a linear range of 10μM-1.0mM, with detection limits at the low and ultra-low μM levels (i.e. <1.0μM) and satisfactory precision (RSD=3.6-12.6%). The sensor has been tested for the assessment of antioxidant activity in real samples (teas and wines) and the results correlated well with commonly used antioxidant detection methods. Importantly, the sensor performed favorably for long periods of time when stored at moisture-free and low temperature conditions without losing its activity thus posing as an attractive alternative to the assessment of antioxidant activity without specialized equipment. The use of the sensor by non-experts for a rapid assessment of natural products in field testing is envisioned. Importantly, we demonstrate for the first time that analyte-mediated growth of nanomaterials directly on the paper surface could open new opportunities in paper-based analytical devices. Copyright © 2014 Elsevier B.V. All rights reserved.
    Analytica Chimica Acta 02/2015; 860C:61-69. DOI:10.1016/j.aca.2014.12.025 · 4.51 Impact Factor
  • Source
    • "bolus of either trimetazidine (Downey, 1990) or SOD (Flaherty et al., 1994) showed no beneficial effects on the outcome of patients. Moreover, p.o. administration of vitamin C (Chen et al., 2013) or the effects of combined vitamins C and E, through infusion and capsules (Jaxa-Chamiec et al., 2005; Lee et al., 2005; Cook et al., 2007), did not demonstrate a major effect of these antioxidant treatments on the clinical outcome of patients. Nevertheless , in diabetic patients, a reduction in 30 day cardiac mortality has been reported (Jaxa-Chamiec et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The morbidity and mortality from coronary artery disease (CAD) remain significant worldwide. The treatment for acute myocardial infarction has improved over the past decades, including early reperfusion of culprit coronary arteries. Although it is mandatory to reperfond the ischemic territory as soon as possible, paradoxically this leads to additional myocardial injury, namely ischemia/reperfusion injury, in which a pivotal role is played by redox stress and for which no effective therapy is currently available. In this review, we report evidence that redox environment plays pivotal roles not only in ischemia/reperfusion injury, but also in cardioprotection. In fact cardioprotective strategies, such as pre- and post-conditioning, result in a robust reduction of infarct size in animals and redox signaling plays a role of paramount importance in these conditioning strategies. Nitrosative signaling and cysteine redox modifications, such as S-nitrosation/-nitrosylation, are also emerging as very important mechanisms in conditioning cardioprotection. The reasons of the switch from protective oxidative/nitrosative signaling to deleterious oxidative/nitrosative/nitrative stress are not fully understood. The complex regulation of this switch is, at least in part, responsible of the diminished or absent cardioprotection by conditioning protocols observed in aging animals and with comorbidities as well as in humans. Therefore, it is important to understand at a mechanistic level the reasons for these differences before proposing a safe and useful transition of ischemic or pharmacological conditioning. Indeed, more mechanistic novel therapeutic strategies are required to protect the heart from ischemia/reperfusion injury and to improve clinical outcomes in patients with CAD.
    British Journal of Pharmacology 10/2014; 172(8). DOI:10.1111/bph.12975 · 4.84 Impact Factor
Show more


18 Reads
Available from