Clinical Question: Does vitamin E s...

Clinical Question: Does vitamin E supplementation render the risk of cancer and cardiovascular disease?

Setting: Outpatient (any)

application of mind Design: Randomized controlled trial (double-blinded)

Allocation: Concealed

Synopsis: inferences of observational studies report an association between a decrease in cardiovascular risk and an increase in vitamin E in the diet. arises of published short-term controlled trials, however, report a neutral issue of vitamin E supplementation upon cardiovascular disease risk. To assess whether longer treatment duration is effective, the existing investigators extended the Heart results Prevention Evaluation (HOPE) trial, which initially evaluated the imports of vitamin E supplementation upon patients at high risk for cardiovascular events

Of the original 9541 patients who participated in the trust trial for a mean of 45 years, 4723 agreed to participate in an extension research for seven years. Patients were randomized initially in a double-blind fashion to receive vitamin E (400 IU daily) or matched placebo. thorough follow-up occurred for more than 99 percent of participants in the extension trial. issues were assessed by persons blinded to treatment cluster assignment.

Using intention-to-treat analysis, no significant differences were noted between the vitamin E supplementation assemblage and the control group in the incidence of cancer or deaths related to cancer. There also were no differences in the main composite of cardiovascular issues including death or rehospitalization. A significant increased risk in heart failure and related complications occurr in the vitamin E form into groups (number needed to treat to harm = 61 for seven years; 95% confidence interval, 35 to 235) These ensues are supported by a modern meta-analysis that found no benefit and a slightly higher rate of death in patients taking high-dose vitamin E (Miller ER 3rd Pastor-Barriuso R Dalal D Riemersma RA, Appel LJ Guallar E Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern M 2005;142:37-46)

Bottom Line: Vitamin E supplementation does not cut down the risk of cancer or major cardiovascular incidents in patients at high risk for vascular disease, and may increase the risk of heart failure. (Level of Evidence: 1b)

DAVID SLAWSON, MD

cogitation Reference: Lonn E, et al., and the waiting under the possibility of fulfilment and HOPE-TOO Trial Investigators. validitys of long-term vitamin E supplementation onward cardiovascular events and cancer: a randomized controll trial. JAMA March 16 2005;293:1338-47

Used with permission from Slawson D Vitamin E may increase risk for heart failure. Accessed online June 1 2005 at: http://www.InfoPOEMs.com.

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