Effect of Supplemental Vitamin E for the Prevention and Treatment of Cardiovascular Disease

Southern California Evidence-Based Practice Center, Rand Corporation, Santa Monica, California, USA.
Journal of General Internal Medicine (Impact Factor: 3.45). 05/2004; 19(4):380-9. DOI: 10.1111/j.1525-1497.2004.30090.x
Source: PubMed


To evaluate and synthesize the evidence on the effect of supplements of vitamin E on the prevention and treatment of cardiovascular disease.
Systematic review of placebo-controlled randomized controlled trials; meta-analysis where justified.
Eighty-four eligible trials were identified. For the outcomes of all-cause mortality, cardiovascular mortality, fatal or nonfatal myocardial infarction, and blood lipids, neither supplements of vitamin E alone nor vitamin E given with other agents yielded a statistically significant beneficial or adverse pooled relative risk (for example, pooled relative risk of vitamin E alone = 0.96 [95% confidence interval (CI), 0.84 to 1.10]; 0.97 [95% CI, 0.80 to 1.90]; and 0.72 [95% CI, 0.51 to 1.02] for all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction, respectively.
There is good evidence that vitamin E supplementation does not beneficially or adversely affect cardiovascular outcomes.

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    • "The analysis of our secondary outcomes revealed a tendency but no significant improvement in HOMA-IR, postprandial glucose and blood pressure in the vitamin E group compared with controls. In addition, vitamin E supplementation had no significant effect on lipid metabolism, which was consistent with the findings of an earlier meta-analysis by Shekelle PG [43]. "
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    ABSTRACT: Observational studies have revealed that higher serum vitamin E concentrations and increased vitamin E intake and vitamin E supplementation are associated with beneficial effects on glycaemic control in type 2 diabetes mellitus (T2DM). However, whether vitamin E supplementation exerts a definitive effect on glycaemic control remains unclear. This article involves a meta-analysis of randomised controlled trials of vitamin E to better characterise its impact on HbA1c, fasting glucose and fasting insulin. PubMed, EMBASE and the Cochrane Library were electronically searched from the earliest possible date through April 2013 for all relevant studies. Weighted mean difference (WMD) was calculated for net changes using fixed-effects or random-effects models. Standard methods for assessing statistical heterogeneity and publication bias were used. Fourteen randomised controlled trials involving individual data on 714 subjects were collected in this meta-analysis. Increased vitamin E supplementation did not result in significant benefits in glycaemic control as measured by reductions in HbA1c, fasting glucose and fasting insulin. Subgroup analyses revealed a significant reduction in HbA1c (-0.58%, 95% CI -0.83 to -0.34) and fasting insulin (-9.0 pmol/l, 95% CI -15.90 to -2.10) compared with controls in patients with low baseline vitamin E status. Subgroup analyses also demonstrated that the outcomes may have been influenced by the vitamin E dosage, study duration, ethnic group, serum HbA1c concentration, and fasting glucose control status. In conclusion, there is currently insufficient evidence to support a potential beneficial effect of vitamin E supplementation on improvements of HbA1c and fasting glucose and insulin concentrations in subjects with T2DM.
    Full-text · Article · Apr 2014 · PLoS ONE
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    • "Nevertheless, clinical trials failed to support the role of vitamin E supplementation in preventing CVD [131]. Subsequent meta-analyses and systematic reviews of more than 90 trials showed similar null results [132, 133]. Most recently, a dose-response meta-analysis showed increased risk of high-dose vitamin E (≥400 IU/day) on total mortality [17]. "
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    ABSTRACT: Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Dietary factors are important in the pathogenesis of CVD and may to a large degree determine CVD risk, but have been less extensively investigated. Functional foods are those that are thought to have physiological benefits and/or reduce the risk of chronic disease beyond their basic nutritional functions. The food industry has started to market products labelled as "functional foods." Although many review articles have focused on individual dietary variables as determinants of CVD that can be modified to reduce the risk of CVD, the aim of this current paper was to examine the impact of functional foods in relation to the development and progression of CVD. Epidemiologic studies have demonstrated the association between certain dietary patterns and cardiovascular health. Research into the cardio-protective potential of their dietary components might support the development of functional foods and nutraceuticals. This paper will also compare the effect of individual bioactive dietary compounds with the effect of some dietary patterns in terms of their cardiovascular protection.
    Full-text · Article · Apr 2012 · Journal of nutrition and metabolism
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    • "Moreover, cross-sectional studies indicated that supplementation of low molecular weight antioxidants is associated with a relatively low incidence of CVD (Jha et al., 1995). By contrast, in most of the interventional studies the antioxidant supplementation did not prevent the progression of CVD nor did it improve any of the many clinical endpoints (Shekelle et al., 2004; Vivekananthan et al., 2003; Miller 2005; Bjelakovic, 2007; Dotan, 2009a; Dotan, 2009b). Based on these findings, Witztum (Witztum, 1998) and Morrow (Morrow, 2003) hypothesized that only individuals under oxidative stress may benefit from antioxidant supplementation. "

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