Vitamins E and C Fail to Beat Placebo in Preventing Cardiovascular Disease in Older Men

Nov. 10, 2008 - Neither vitamin E nor vitamin C supplements reduced the risk of major cardiovascular events in a large, long-term study of older male physicians, according to a study in the November 12 issue of the Journal of the American Medical Association (JAMA). The article was released early online yesterday to coincide with the scientific presentation of the study findings at the American Heart Association meeting.

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A majority of adults in the United States are reported to have taken vitamin supplements in the past year, according to background information provided by the authors.

"Basic research studies suggest that vitamin E, vitamin C, and other antioxidants reduce cardiovascular disease by trapping organic free radicals, by deactivating excited oxygen molecules, or both, to prevent tissue damage," according to the report.

Some previous observational studies have supported a role for vitamin E in cardiovascular disease prevention. Some previous observational studies have also shown a role for vitamin C in reducing coronary heart disease risk. These earlier studies had opened the door on a rush by Americans – senior citizens, in particular – to taking these supplements to protect them from heart problems.

In this study, known as the Physicians' Health Study II, Howard D. Sesso, Sc.D, M.P.H., and colleagues from Brigham and Women's Hospital, Harvard Medical School and School of Public Health and VA Boston Healthcare System, Boston, assessed the effects of vitamin E and vitamin C supplements on the risk of major cardiovascular disease events among 14,641 male physicians.

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Nov. 17, 2008 – It has not been a good month for vitamins E and C. A study released yesterday found no protective effect from vitamin E on prostate cancer or vitamin C supplementation on total cancer. This follows a study released earlier in the month that says neither vitamin E nor vitamin C supplements reduced the risk of major cardiovascular events in a study of older men. Read more...

These physicians were 50 years or older and at low risk of cardiovascular disease at the beginning of the study in 1997, and 754 (5.1 percent) had prevalent cardiovascular disease. The study participants were randomized to receive 400 IU of vitamin E every other day or a placebo and 500 mg of vitamin C daily or a placebo.

"During a mean (average) follow-up of 8 years, there were 1,245 confirmed major cardiovascular events," the researchers report.

There were 511 total myocardial infarctions (heart attacks), 464 total strokes, and 509 cardiovascular deaths, with some men experiencing multiple events.

A total of 1,661 men died during follow-up.

Compared with placebo, neither vitamin E nor vitamin C had an effect on the prevention of major cardiovascular events.

"Neither vitamin E nor vitamin C had a significant effect on total mortality, but vitamin E was associated with an increased risk of hemorrhagic stroke."

In conclusion the authors write: "In this large, long-term trial of male physicians, neither vitamin E nor vitamin C supplementation reduced the risk of major cardiovascular events. These data provide no support for the use of these supplements for the prevention of cardiovascular disease in middle-aged and older men."

Editor's Note: This work was supported by grants from the National Institutes of Health and an investigator-initiated grant from BASF Corporation. Study agents and packaging were provided by BASF Corporation, Wyeth Pharmaceuticals, and DSM Nutritional Products Inc. (formerly Roche Vitamins). Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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