Article

Effects of Selenium Supplementation on Cardiovascular Disease Incidence and Mortality: Secondary Analyses in a Randomized Clinical Trial

University of Naples Federico II, Napoli, Campania, Italy
American Journal of Epidemiology (Impact Factor: 5.23). 05/2006; 163(8):694-9. DOI: 10.1093/aje/kwj097
Source: PubMed

ABSTRACT

Despite the documented antioxidant and chemopreventive properties of selenium, studies of selenium intake and supplementation and cardiovascular disease have yielded inconsistent findings. The authors examined the effect of selenium supplementation (200 microg daily) on cardiovascular disease incidence and mortality through the entire blinded phase of the Nutritional Prevention of Cancer Trial (1983-1996) among participants who were free of cardiovascular disease at baseline (randomized to selenium: n = 504; randomized to placebo: n = 500). Selenium supplementation was not significantly associated with any of the cardiovascular disease endpoints during 7.6 years of follow-up (all cardiovascular disease: hazard ratio (HR) = 1.03, 95% confidence interval (CI): 0.78, 1.37; myocardial infarction: HR = 0.94, 95% CI: 0.61, 1.44; stroke: HR = 1.02, 95% CI: 0.63, 1.65; all cardiovascular disease mortality: HR = 1.22, 95% CI: 0.76, 1.95). The lack of significant association with cardiovascular disease endpoints was also confirmed when analyses were further stratified by tertiles of baseline plasma selenium concentrations. These findings indicate no overall effect of selenium supplementation on the primary prevention of cardiovascular disease in this population.

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    • "Selenium plays a significant role in the prevention of the oxidative modification of lipids, reducing inflammation and preventing platelets from aggregating [12]. Its supplementation in patients with cardiovascular disease was found to lower the levels of total plasma cholesterol and low-density-lipoprotein (LDL) plasma cholesterol and doses as high as 300 mcg/day significantly increased HDL levels [13] [14] [15]. "
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    • "However, results from randomized trials of Se supplementation do not support a role for Se in cardiovascular prevention [35]. Specifically, in post-hoc analyses from the NPC trial [58], we found that Se supplementation (200 mg/d) was not significantly associated with any of the cardiovascular disease (CVD) endpoints after 7.6 years of follow-up [all CVD "
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    ABSTRACT: Mounting evidence supports the hypothesis that functional foods containing physiologically-active components may be healthful. Longitudinal cohort studies have shown that some food classes and dietary patterns are beneficial in primary prevention, and this has led to the identification of putative functional foods. This field, however, is at its very beginning, and additional research is necessary to substantiate the potential health benefit of foods for which the diet–health relationships are not yet scientifically validated. It appears essential, however, that before health claims are made for particular foods, in vivo randomized, double-blind, placebo-controlled trials of clinical end-points are necessary to establish clinical efficacy. Since there is need for research work aimed at devising personalized diet based on genetic make-up, it seems more than reasonable the latter be modeled, at present, on the Mediterranean diet, given the large body of evidence of its healthful effects.
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