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March 16, 2005

Is There Any Hope for Vitamin E?

Author Affiliations

Author Affiliations: Department of Medicine, Cardiology Division, University of Washington School of Medicine, Seattle (Dr Brown); Department of Cancer Research and Biostatistics, Fred Hutchinson Cancer Research Center; and Department of Biostatistics, University of Washington School of Public Health and Community Medicine, Seattle (Dr Crowley).

JAMA. 2005;293(11):1387-1390. doi:10.1001/jama.293.11.1387

During the past 15 years, epidemiological,1,2 basic biological,35 and experimental studies on atherosclerosis have supported the hypothesis that antioxidants protect against atherosclerosis68 by limiting low-density lipoprotein oxidation in the arterial wall. This mechanism inhibits the pathological accumulation of cholesteryl ester in plaque via the macrophage scavenger receptor, a process that can cause plaque rupture and cardiovascular events.9,10 Similarly, biological mechanisms have been identified in carcinogenesis that may be blocked by antioxidants.1114 In the past decade, a number of prospective, randomized, placebo-controlled, 3- to 6-year clinical trials have been published, testing the effect of vitamin E and other antioxidant vitamins or their combinations on clinical manifestations of cardiovascular disease and cancer.1521 These trials have surprisingly yet consistently shown that commonly used antioxidant vitamin regimens (vitamins E, C, beta carotene, or a combination) do not significantly reduce overall cardiovascular events or cancer.

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