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Although a large number of people continue to take vitamin supplements, the long-term health benefits remain unclear.\u00a0 Both vitamins C and E have antioxidant properties that have the potential to slow plaque progression.<\/p>\n
The Physicians’ Health Study II was a randomized, double-blind, placebo-controlled factorial trial of vitamin E and vitamin C that ran from 1997 – 2007.\u00a0 14\u00a0641 US male physicians aged over 50 enrolled,\u00a0 754 of whom (5.1%) had cardiovascular disease at randomization.\u00a0 Participants were given supplements of 400 IU of vitamin E every other day and 500 mg of vitamin C daily.\u00a0 The main outcome measure was a composite end point of major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, and cardiovascular disease death.<\/p>\n
Over a mean follow-up of 8 years, there were 1245 confirmed major cardiovascular events. Vitamin E had no effect on the incidence of major cardiovascular events when compared to placebo (both active and placebo vitamin E groups, 10.9 events per 1000 person-years; hazard ratio [HR], 1.01; P<\/em> =\u00a0.86), nor was any difference seen in total myocardial infarction (HR, 0.90 ; P<\/em> =\u00a0.22), total stroke (HR, 1.07; P<\/em> =\u00a0.45), and cardiovascular mortality (HR, 1.07; P<\/em> =\u00a0.43). In addition, there was no significant effect of vitamin C on major cardiovascular events (active and placebo vitamin E groups, 10.8 and 10.9 events per 1000 person-years, respectively; HR, 0.99; P<\/em> =\u00a0.91), total myocardial infarction (HR, 1.04; P<\/em> =\u00a0.65), total stroke (HR, 0.89; P<\/em> =\u00a0.21), or cardiovascular mortality (HR, 1.02; P<\/em> =\u00a0.86). Neither vitamin E (HR, 1.07; P<\/em> =\u00a0.15) nor vitamin C (HR, 1.07; P<\/em> =\u00a0.16) had a significant effect on total mortality.\u00a0 An increased risk of hemorrhagic stroke was noted with vitamin E(HR, 1.74; P<\/em> =\u00a0.04).<\/p>\n There currently exists no role for either vitamins C or E in cardiovascular prevention strategy.\u00a0 Although other supplements such as vitamin D and omega-3 fatty acids are currently under investigation, for now the nutritional emphasis in primary prevention should be placed on a maintaining a healthy, balanced diet.<\/p>\n