Antioxidants and Cardiovascular Disease: Why Do We Still Not Have the Answers?
Authors: Thomas C. Chalmers
Journal: Annals of Internal Medicine (1995)

Editorials1 December 1995Antioxidants and Cardiovascular Disease: Why Do We Still Not Have the Answers?Thomas C. ChalmersThomas C. ChalmersMetaworks, Inc. Boston, MA 02109Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-11-199512010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, Jha and colleagues [1] provide an excellent review of the published prospective epidemiologic studies and randomized, controlled trials with more than 100 patients that address the possibility that supplementary antioxidant vitamins (E, C, and β-carotene) prevent cardiovascular disease and reduce overall mortality rates. The question is important because it is entirely possible that reducing cholesterol levels, cigarette smoking, and blood pressure; increasing exercise; and controlling diabetes have achieved all that they will achieve except through greater compliance, and it may be time to explore other channels of opportunity. As Jha and colleagues [1] point out, suspicion of ...References1. Jha P, Flather M, Lonn E, Farkouh M, Yusuf S. The antioxidant vitamins and cardiovascular disease. A critical review of epidemiologic and clinical trial data. Ann Intern Med. 1995; 123:860-72. Google Scholar2. Teo KK, Yusuf S, Collins R, Held PH, Peto R. Effects of intravenous magnesium in suspected acute myocardial infarction: overview of randomised trials. BMJ. 1991; 303:1499-503. Google Scholar3. Woods KL, Fletcher S, Roffe C, Haider Y. Intravenous magnesium sulphate in suspected acute myocardial infarction: results of the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2). Lancet. 1992; 339:1553-8. Google Scholar4. “ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. ISIS-4 (Fourth International Study of Infarct Survival). Lancet. 1995; 345:669-85.” Google Scholar5. Woods KL. Mega-trials and management of acute myocardial infarction. Lancet. 1995; 346:611-4. Google Scholar6. Antman EM, Lau HJ, Chalmers TC, Mosteller F. Large versus small trials of magnesium for myocardial infarction: big numbers do not tell the whole story. Presented to the 67th session of the American Heart Association, Dallas, Texas, November 1994. Google Scholar7. Schmid CH, McIntosh M, Cappelleri JC, Lau J, Chalmers TC. Measuring the impact of the control rate in meta-analysis of clinical trials. Control Clin Trials. 1995; 16:66S. Google Scholar8. Lau J, Chalmers TC, Mosteller F. How many you need depends on what is already known. Estimating the size of future randomized control trials based on meta-analyses. Presented to the 13th annual meeting of the International Society of Clinical Biostatistics, Copenhagen, Denmark, August 1992. Google Scholar Author, Article, and Disclosure InformationAuthors: Thomas C. ChalmersAffiliations: Metaworks, Inc. Boston, MA 02109Corresponding Author: Thomas C. Chalmers, MD, 32 Pinewood Village, West Lebanon, NH 03784. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Antioxidant Vitamins and Cardiovascular Disease: A Critical Review of Epidemiologic and Clinical Trial Data Prabhat Jha , Marcus Flather , Eva Lonn , Michael Farkouh , and Salim Yusuf Metrics Cited byRealism in evidence based medicine: interpreting the randomised controlled trialAntioxiderende vitamines, cardiovasculaire ziekten en kankerIron and Heart Disease 1 December 1995Volume 123, Issue 11Page: 887KeywordsAntioxidantsCardiovascular diseasesDeath ratesEpidemiologyMagnesiumProspective studiesRandomized trialsResearch designRetrospective studiesVitamin E ePublished: 15 August 2000 Issue Published: 1 December 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...