High-Dosage Vitamin E Supplementation and All-Cause Mortality (2005)

Letters19 July 2005High-Dosage Vitamin E Supplementation and All-Cause MortalityEdgar R. Miller III, MD, PhD, Lawrence J. Appel, MD, MPH, Eliseo Guallar, MD, DrPH, and Roberto Pastor-Barriuso, PhDEdgar R. Miller III, MD, PhDFrom Johns Hopkins Medical Institutions, Baltimore, MD 21205, and Instituto de Salud Carlos III, 28029 Madrid, Spain., Lawrence J. Appel, MD, MPHFrom Johns Hopkins Medical Institutions, Baltimore, MD 21205, and Instituto de Salud Carlos III, 28029 Madrid, Spain., Eliseo Guallar, MD, DrPHFrom Johns Hopkins Medical Institutions, Baltimore, MD 21205, and Instituto de Salud Carlos III, 28029 Madrid, Spain., and Roberto Pastor-Barriuso, PhDFrom Johns Hopkins Medical Institutions, Baltimore, MD 21205, and Instituto de Salud Carlos III, 28029 Madrid, Spain.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-2-200507190-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Since the publication of our vitamin E dose–response meta-analysis, we have received hundreds of e-mails, letters, and phone calls as well as more than 40 Letters to the Editor submitted electronically. Annals has asked us to prepare a written response to 11 selected letters.Blatt and Pryor and Krishnan and associates hypothesize that natural vitamin E supplements have greater benefit than synthetic vitamin E supplements, even though no trial has directly compared them on mortality outcomes. In response, we have performed a subgroup analysis comparing the 4 trials using natural supplements, all high-dosage (400 IU/d), with high-dosage trials ...References1. Yusuf S, Dagenais G, Pogue J, Bosch J, Sleight P. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342:154-60. [PMID: 10639540] CrossrefMedlineGoogle Scholar2. McNeil JJ, Robman L, Tikellis G, Sinclair MI, McCarty CA, Taylor HR. Vitamin E supplementation and cataract: randomized, controlled trial. Ophthalmology. 2004;111:75-84. [PMID: 14711717] CrossrefMedlineGoogle Scholar3. Stephens NG, Parsons A, Schofield PM, Kelly F, Cheeseman K, Mitchinson MJ. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. 1996;347:781-6. [PMID: 8622332] CrossrefMedlineGoogle Scholar4. Mitchinson MJ, Stephens NG, Parsons A, Bligh E, Schofield PM, Brown MJ. Mortality in the CHAOS trial [Letter]. Lancet. 1999;353:381-2. [PMID: 9950454] CrossrefMedlineGoogle Scholar5. Boaz M, Smetana S, Weinstein T, Matas Z, Gafter U, Iaina A, et al. Secondary prevention with antioxidants of cardiovascular disease in endstage renal disease (SPACE): randomised placebo-controlled trial. Lancet. 2000;356:1213-8. [PMID: 11072938] CrossrefMedlineGoogle Scholar6. Lee IM, Cook NR, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE. A randomized trial of vitamin E in the primary prevention of cardiovascular disease in 39, 876 women: The Women's Health Study. American College of Cardiology Annual Scientific Session, 7 March 2005. Accessed at www.acc05online.acc.org/highlights/keyLectures.aspx?sessionId=8030&&date=7 on 23 March 2005. Google Scholar7. Pastor-Barriuso R, Guallar E, Coresh J. Transition models for change-point estimation in logistic regression. Stat Med. 2003;22:1141-62. [PMID: 12652559] CrossrefMedlineGoogle Scholar8. Goetghebeur E, Pocock SJ. Detection and estimation of J-shaped risk-response relationships. Journal of the Royal Statistical Society [A]. 1995;158:107-21. CrossrefGoogle Scholar9. Egger M, Smith GD, Altman DG, eds. Systematic Reviews in Health Care. Meta-Analysis in Context. 2nd ed. London: BMJ Books; 2001. Google Scholar10. Fang JC, Kinlay S, Beltrame J, Hikiti H, Wainstein M, Behrendt D, et al. Effect of vitamins C and E on progression of transplant-associated arteriosclerosis: a randomised trial. Lancet. 2002;359:1108-13. [PMID: 11943259] CrossrefMedlineGoogle Scholar11. Salonen JT, Nyyssonen K, Salonen R, Lakka HM, Kaikkonen J, Porkkala-Sarataho E, et al. Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study: a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis. J Intern Med. 2000;248:377-86. [PMID: 11123502] CrossrefMedlineGoogle Scholar12. Salonen RM, Nyyssonen K, Kaikkonen J, Porkkala-Sarataho E, Voutilainen S, Rissanen TH, et al. Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression: the Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) Study. Circulation. 2003;107:947-53. [PMID: 12600905] CrossrefMedlineGoogle Scholar13. Lonn E, Yusuf S, Dzavik V, Doris C, Yi Q, Smith S, et al. Effects of ramipril and vitamin E on atherosclerosis: the study to evaluate carotid ultrasound changes in patients treated with ramipril and vitamin E (SECURE). Circulation. 2001;103:919-25. [PMID: 11181464] CrossrefMedlineGoogle Scholar14. Hodis HN, Mack WJ, LaBree L, Mahrer PR, Sevanian A, Liu CR, et al. Alpha-tocopherol supplementation in healthy individuals reduces low-density lipoprotein oxidation but not atherosclerosis: the Vitamin E Atherosclerosis Prevention Study (VEAPS). Circulation. 2002;106:1453-9. [PMID: 12234947] CrossrefMedlineGoogle Scholar15. Waters DD, Alderman EL, Hsia J, Howard BV, Cobb FR, Rogers WJ, et al. Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary atherosclerosis in postmenopausal women: a randomized, controlled trial. JAMA. 2002;288:2432-40. [PMID: 12435256] CrossrefMedlineGoogle Scholar16. Brown BG, Zhao XQ, Chait A, Fisher LD, Cheung MC, Morse JS, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med. 2001;345:1583-92. [PMID: 11757504] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins Medical Institutions, Baltimore, MD 21205, and Instituto de Salud Carlos III, 28029 Madrid, Spain.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality Edgar R. Miller III , Roberto Pastor-Barriuso , Darshan Dalal , Rudolph A. Riemersma , Lawrence J. Appel , and Eliseo Guallar Brief Communication: The Prevalence of High Intake of Vitamin E from the Use of Supplements among U.S. Adults Earl S. Ford , Umed A. Ajani , and Ali H. Mokdad An Editorial Update: Annus horribilis for Vitamin E Eliseo Guallar , Daniel F. Hanley , and Edgar R. Miller III High-Dosage Vitamin E Supplementation and All-Cause Mortality David H. Blatt and William A. Pryor High-Dosage Vitamin E Supplementation and All-Cause Mortality Koyamangalath Krishnan , Sharon Campbell , and William L. Stone High-Dosage Vitamin E Supplementation and All-Cause Mortality Harri Hemilä High-Dosage Vitamin E Supplementation and All-Cause Mortality Wee-Shiong Lim , Rajka Liscic , Chengjie Xiong , and John C. Morris High-Dosage Vitamin E Supplementation and All-Cause Mortality Connie Marras , Anthony E. Lang , David Oakes , Michael P. McDermott , Karl Kieburtz , Ira Shoulson , Caroline M. Tanner , and Stanley Fahn High-Dosage Vitamin E Supplementation and All-Cause Mortality Simin Nikbin Meydani , Joseph Lau , Gerard E. Dallal , and Mohsen Meydani High-Dosage Vitamin E Supplementation and All-Cause Mortality Kent J. DeZee , William Shimeall , Kevin Douglas , and Jeffrey L. Jackson High-Dosage Vitamin E Supplementation and All-Cause Mortality Antonio M. Possolo High-Dosage Vitamin E Supplementation and All-Cause Mortality Ishwarlal Jialal and Sridevi Devaraj High-Dosage Vitamin E Supplementation and All-Cause Mortality Thomas Carter High-Dosage Vitamin E Supplementation and All-Cause Mortality Joseph E. Baggott Metrics Cited byThe relevant targets of anti-oxidative stress: a reviewAtherogenesis, the oxidative LDL modification hypothesis revisitedNo evidence supports vitamin E indiscriminate supplementationDecision Analysis Supports the Paradigm That Indiscriminate Supplementation of Vitamin E Does More Harm than GoodRegulation of the insulin antagonistic protein tyrosine phosphatase 1B by dietary Se studied in growing ratsAbstractsBrief Communication: The Prevalence of High Intake of Vitamin E from the Use of Supplements among U.S. AdultsEarl S. Ford, MD, MPH, Umed A. Ajani, MBBS, MPH, and Ali H. Mokdad, PhD 19 July 2005Volume 143, Issue 2Page: 156-158KeywordsAtherosclerosisHeartLongitudinal studiesObstetrics and gynecologyPopulation statisticsResearch designVitamin CVitamin E ePublished: 19 July 2005 Issue Published: 19 July 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...