Alpha-tocopherol supplementation in healthy individuals reduces low-density lipoprotein oxidation but not atherosclerosis: the Vitamin E Atherosclerosis Prevention Study (VEAPS).
BACKGROUND
Epidemiological studies have demonstrated an inverse relationship between vitamin E intake and cardiovascular disease (CVD) risk. In contrast, randomized controlled trials have reported conflicting results as to whether vitamin E supplementation reduces atherosclerosis progression and CVD events.


RESULTS
The study population consisted of men and women > or =40 years old with an LDL cholesterol level > or =3.37 mmol/L (130 mg/dL) and no clinical signs or symptoms of CVD. Eligible participants were randomized to DL-alpha-tocopherol 400 IU per day or placebo and followed every 3 months for an average of 3 years. The primary trial end point was the rate of change in the common carotid artery far-wall intima-media thickness (IMT) assessed by computer image-processed B-mode ultrasonograms. A mixed effects model using all determinations of IMT was used to test the hypothesis of treatment differences in IMT change rates. Compared with placebo, alpha-tocopherol supplementation significantly raised plasma vitamin E levels (P<0.0001), reduced circulating oxidized LDL (P=0.03), and reduced LDL oxidative susceptibility (P<0.01). However, vitamin E supplementation did not reduce the progression of IMT over a 3-year period compared with subjects randomized to placebo.


CONCLUSIONS
The results are consistent with previous randomized controlled trials and extend the null results of vitamin E supplementation to the progression of IMT in healthy men and women at low risk for CVD.
Hodis
Howard N
HN
Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, Calif, USA. watcher@usc.edu
Mack
Wendy J
WJ
LaBree
Laurie
L
Mahrer
Peter R
PR
Sevanian
Alex
A
Liu
Chao-ran
CR
Liu
Ci-hua
CH
Hwang
Juliana
J
Selzer
Robert H
RH
Azen
Stanley P
SP
D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000517:prevention & control*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D019587:Dietary Supplements; D018450:Disease Progression; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D024502:alpha-Tocopherol / Q000008:administration & dosage / Q000627:therapeutic use*
D000975:Antioxidants; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D024502:alpha-Tocopherol