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July 27, 2005

Vitamin E Supplementation, Cardiovascular Events, and Cancer—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294(4):425-426. doi:10.1001/jama.294.4.426-a

In Reply: Dr Richey raises the potential confounding effect of glitazone use on heart failure. We did not collect detailed data on glitazone use in HOPE and HOPE-TOO because the trial was designed in the early 1990s, before recognition of the potential impact of glitazones on heart failure. However, HOPE is a randomized double-blind trial, so that it is unlikely that glitazones would be preferentially used in the vitamin E group. Furthermore, we did collect data on overall use of oral hypoglycemic agents and this was similar in the vitamin E and placebo groups (22.2% vs 21.4% at baseline, 23.8% vs 21.3% at 4 years, and 24.5% vs 24.6% at study end, respectively). We have previously reported that vitamin E has a neutral effect on glycemic control and on the development of new-onset diabetes mellitus,1 which further makes a differential use of glitazones unlikely.