This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (31)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Nutritional and Metabolic Disorders  • Lipids and Lipid Disorders  • Review  • Alert me on articles by topic  Social Bookmarking   What's this?

Anne P. Spencer, PharmD; Deborah Stier Carson, PharmD; Michael A. Crouch, PharmD

Arch Intern Med. 1999;159:1313-1320.

Various studies have evaluated the antioxidant effects of vitamin E in the prevention or treatment of coronary artery disease (CAD). In vitro data suggest that vitamin E protects against oxidation of low-density lipoprotein and decreases the deposition of atherogenic oxidized low-density lipoprotein in arterial walls. Various observational and epidemiological studies also suggest a relationship between vitamin E serum concentrations or intake and CAD. One prospective, randomized trial suggested that low-dosage vitamin E supplementation (50 IU/d) decreases the risk of angina in patients without previously diagnosed CAD. Another study, using high-dosage vitamin E supplementation (400 or 800 IU/d), demonstrated a decrease in the combined end point of nonfatal myocardial infarction and cardiovascular death in patients with established CAD. Discordant data, however, have been published that imply no cardiovascular benefit of low-dosage vitamin E supplementation (50 IU/d) and detrimental effects if vitamin E is combined with beta carotene. At this point, clinicians should emphasize a low-fat diet with high intake of fruits and vegetable sources containing vitamin E. Supplemental vitamin E may be considered in patients at high risk for CAD or with documented CAD, but the potential beneficial effects should be weighed against possible long-term adverse effects. If vitamin E supplementation is initiated, the literature suggests dosages of 100 to 400 IU/d, with the higher dosage considered in patients with documented CAD. Additional investigation is warranted to further define the role of vitamin E supplementation in CAD and to critically evaluate the optimal dosage, duration of use, and method of consumption (dietary vs supplemental).

From the Medical University of South Carolina, Charleston (Drs Spencer and Carson), and the Virginia Commonwealth University—Medical College of Virginia Campus, Richmond (Dr Crouch).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Antioxidant Therapy for Coronary Artery Disease: Don't Paint the Walls Without Treating the Termites!
Gordon A. Ewy
Arch Intern Med. 1999;159(12):1279-1280.
EXTRACT | FULL TEXT  

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 1999;159(12):1378.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lipid standardization of serum fat-soluble antioxidant concentrations: the YALTA study
Gross et al.
Am. J. Clin. Nutr. 2003;77:458-466.
ABSTRACT | FULL TEXT  

Serum Antioxidant Vitamins and Blood Pressure in the United States Population
Chen et al.
Hypertension 2002;40:810-816.
ABSTRACT | FULL TEXT  

Decreased Atherosclerotic Lesion Formation in Human Serum Paraoxonase Transgenic Mice
Tward et al.
Circulation 2002;106:484-490.
ABSTRACT | FULL TEXT  

Status of myocardial antioxidants in ischemia-reperfusion injury
Dhalla et al.
Cardiovasc Res 2000;47:446-456.
ABSTRACT | FULL TEXT  

Antioxidant Therapy for Coronary Artery Disease: Don't Paint the Walls Without Treating the Termites!
Ewy
Arch Intern Med 1999;159:1279-1280.
FULL TEXT