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Correspondence
November 2006

Heart Outcomes Prevention Evaluation–The Ongoing Outcomes Study, Vitamin E, and Age-Related Macular Degeneration—Reply

Arch Ophthalmol. 2006;124(11):1665-1666. doi:10.1001/archopht.124.11.1665-b

In reply

In a previous editorial,1we reported that currently published data demonstrate no apparent association of the use of vitamin E at 400 IU/d with mortality. The article from the Heart Outcomes Prevention Evaluation–The Ongoing Outcomes (HOPE-TOO) trial2has raised the possibility that vitamin E supplementation may increase heart failure morbidity. This study was an extension of the original HOPE study that tested the role of vitamin E in the prevention of cancer and cardiovascular disease. The primary outcome measures included incident cancers, cancer deaths, and a composite cardiovascular outcome that included myocardial infarction, stroke, cardiovascular death, unstable angina, revascularization, and total mortality. Both the HOPE and HOPE-TOO studies found neither beneficial nor harmful effects of vitamin E for the main outcome measures. Specifically, there were no harmful effects on overall cardiovascular mortality in the extension of this randomized trial of vitamin E. Each of the components of overall cardiovascular mortality was also assessed. Reported secondary outcomes evaluated included all-cause death, hospitalization for unstable angina, revascularization, or limb amputation, and hospitalization for heart failure with clinical and radiological documentation of heart failure, regardless of the need for hospitalization.

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