Vitamin E supplementation in the prevention of coronary heart disease

Sandhya Pruthi, Thomas G. Allison, Donald D. Hensrud

Research output: Contribution to journalReview articlepeer-review

50 Scopus citations


Vitamin E consists of a number of compounds, tocopherols and tocotrienols, that function as lipid-soluble antioxidants. A hypothesis is that vitamin E may slow the progression of atherosclerosis by blocking the oxidative modification of low-density lipoprotein cholesterol and thus decrease its uptake into the arterial lumen. Basic science and animal studies have generally supported this hypothesis. Observational studies have primarily assessed patients with no established coronary heart disease (CHD), and results have generally supported a protective role of vitamin E in CHD. Early primary and secondary prevention clinical trials (Alpha-Tocopherol, Beta-Carotene Cancer Protection study and Cambridge Heart Antioxidant Study) showed mixed results. Despite years of encouraging evidence from basic science and observational studies, 3 large randomized clinical trials (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico, Heart Outcomes Prevention Evaluation, and Primary Prevention Project) with a combined total of more than 25,000 patients failed to show a significant benefit with vitamin E taken as a dietary supplement for the prevention of CHD. Four large randomized primary prevention trials currently under way should add to our knowledge. The American Heart Association has recommended consumption of a balanced diet with emphasis on antioxidant-rich fruits and vegetables but has made no recommendations regarding vitamin E supplementation for the general population. Although vitamin E supplementation seems to be safe for most people, recommendations from health care professionals should reflect the uncertainty of established benefit as demonstrated in clinical trials.

Original languageEnglish (US)
Article number62503
Pages (from-to)1131-1136
Number of pages6
JournalMayo Clinic proceedings
Issue number11
StatePublished - Nov 2001


  • ATBC = alpha-tocopherol, beta-carotene cancer prevention
  • CHAOS = cambridge heart antioxidant study
  • CHD = coronary heart disease
  • GISSI = gruppo italiano per lo studio della sopravvivenza nell'infarto miocardico
  • HOPE = heart outcomes prevention evaluation
  • LDL = low-density lipoprotein
  • PPP = primary prevention project
  • PUFA = polyunsaturated fatty acid

ASJC Scopus subject areas

  • General Medicine


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