Therapeutic uses of vitamin E in prevention of atherosclerosis.
The purpose of this review is to present the evidence-based pharmacotherapeutic properties of vitamin E and provide clinical recommendations for use in the arena of atherosclerosis.


METHODS
A literature search was conducted from 1966 through March 1999. All usable papers were retrieved, with large, randomized, double-blinded, clinical trials and epidemiological trials receiving emphasis.


RESULTS
Vitamin E, a lipid soluble vitamin, is a potent antioxidant. Several epidemiological studies have demonstrated positive relationships between vitamin E intake and the prevention of atherosclerotic heart disease; however, only one, large randomized clinical trial (The CHAOS Trial) has been conducted using more than 400 IU per day of vitamin E. Positive outcomes included a 77-percent reduction in nonfatal myocardial infarction (MI), but no corresponding reduction in mortality. Several large clinical trials are ongoing, investigating vitamin E for the prevention of atherosclerosis. Much less work has been undertaken studying vitamin E for prevention of cerebro- and peripheral vascular disease, but there appears to be promise in these areas as well.


CONCLUSIONS
On the basis of the literature search, the authors recommend 400 IU or more per day of vitamin E to patients at high risk or already diagnosed with coronary artery disease. Vitamin E supplementation may also be beneficial in the prevention of cerebro- and peripheral vascular diseases.
Swain
R A
RA
Family and Sports Medicine, West Virginia University, Charleston, WV, USA.
Kaplan-Machlis
B
B
D000975:Antioxidants / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D014810:Vitamin E / Q000378:metabolism* / Q000627:therapeutic use*
D000975:Antioxidants; D014810:Vitamin E