Positive Health Online

Abstract

HAYDEN and others, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, khayden@duke.edu, present the Cache county study on vitamin E and the risk of death from cardiovascular disease.

Background

A recent meta-analysis reported increased mortality in clinical trial participants randomized to high-dose vitamin E. The aim of this study was to determine whether these mortality risks with vitamin E reflect adverse consequences of its use in the presence of cardiovascular disease.

Methodology

In a defined population aged 65 years or older, baseline interviews captured self- or proxy-reported history of cardiovascular illness. A medicine cabinet inventory verified nutritional supplement and medication use. Three sources identified subsequent deaths. Cox proportional hazards methods examined the association between vitamin E use and mortality.

Results

After adjustment for age and sex, there was no association in this population between vitamin E use and mortality (adjusted hazard ratio 0.93). Predictably, deaths were more frequent with a history of diabetes, stroke, coronary artery bypass graft surgery, or myocardial infarction, and with the use of warfarin, nitrates, or diuretics. None of these conditions or treatments altered the null main effect with vitamin E. However mortality was increased in vitamin E users who had a history of stroke (hazard ratio 3.64), coronary bypass graft surgery (hazard ratio 4.40), or myocardial infarction (hazard ratio 1.95) and, independently, in those taking nitrates (hazard ratio 3.95), warfarin (hazard ratio 3.71), or diuretics (hazard ratio 1.83). Although not definitive, a consistent trend toward reduced mortality was seen in vitamin E users without these conditions or treatments.

Conclusion

In this population-based study, vitamin E use was unrelated to mortality, but this apparently null finding seems to represent a combination of increased mortality in those with severe cardiovascular disease and a possible protective effect in those without.

References

Hayden KM, Welsh-Bohmer KA, Wengreen HJ, Zandi PP, Lyketsos CG, Breitner JC, Cache County Investigators. Risk of mortality with vitamin E supplements: the Cache County study.  American Journal of Medicine 120 (2): 180-184, Feb 2007.