Abstract
Despite the proliferation of advertisements touting the benefits of antioxidant vitamins on cardiovascular disease in consumer magazines and on the Internet, this hypothesis has not yet been proven. Basic science and animal research studies have provided plausible biologic mechanisms and some, but not all, observational epidemiologic studies indicate that individuals who self-select for antioxidant vitamins have decreased risks of cardiovascular disease. However, since the benefits postulated are small to moderate in size, the most reliable data on which to base public health recommendations regarding the use of antioxidant supplements will be provided by large-scale randomized trials of sufficient size, dose, and duration. Ultimately, a judgment of benefit, no effect, or harm associated with the use of antioxidant vitamins must be based on an evaluation of the totality of evidence from all these research disciplines.
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References
Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993; 328:1444–9.
Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC. Vitamin E consumption and the risk of coronary disease in men. N Engl J Med 1993; 328:1450–6.
Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 1996; 334:1156–62.
Gey FK, Moser UK, Jordan P, Stahlein HB, Eichholzer M, Ludin E. Increased risk of cardiovascular disease at suboptimal plasma concentrations of essential antioxidants: an epidemiologic update with special attention to carotene and vitamin C. Am J Clin Nutr 1993; 57(suppl):787S–797S.
Morris DL, Kritchevsky SB, Davis CE. Serum carotenoids and coronary heart disease: The Lipid Research Clinics Coronary Primary Prevention Trial and Follow-up Study. JAMA 1994; 272:1439–1441.
Street DA, Comstock GW, Salkeld RM, Schuep W. Klag MA. Serum antioxidants and myocardial infarction: are low levels of carotenoids and alpha-tocopherol risk factors for myocardial infarction? Circulation 1994; 90:1154–61.
Blot WJ, Li J-Y, Taylor PR, Guo W, Dawsey S, Wang G-Q, Yang CS, Zheng S-F, Gail M, Li G-Y, Yu Y, Liu B-q, Tangrea J, Sun Y-h, Liu F, Fraumeni JF, Zhang Y-H, Li B. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993;85:1483–92.
The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029–35.
Omenn GS, Goodman GE, Thornquist MD, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 1996;334:1150–5.
Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 1996;334:1145–9.
Gaziano JM, Manson JE, Ridker PM, Buring JE, Hennekens CH. Beta carotene therapy for chronic stable angina. Circulation 1990;82(Suppl III):202.
Stephens NG, Parsons A, Schofield PM, Kelly F, Cheeseman K, Mitchinson MJ, Brown MJ. Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996;347:781–6.
The HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluation) Study. The design of a large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. Can J Cardiol 1996;12:127–37.
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.
Christen WG, Gaziano JM, Hennekens CH, for the Steering Committee of Physicians’ Health Study II. Design of Physicians’ Health Study 1I: A randomized trial of beta-carotene, vitamins E and C, and multivitamins in prevention of cancer, cardiovascular disease, and eye disease - and review of results of completed trials. Ann Epidemiol 2000; 10:125–134.
Buring JE, Hennekens CH. The Women’s Health Study: summary of the study design. J Myocardial Ischemia 1992; 4:27–9.
Hercherg S, Preziosi P, Briançon S, Galan P, Triol I, Malvy D, Roussel A-M, Favier A. A primary prevention trial using nutritional doses of antioxidant vitamins and minerals in cardiovascular diseases and cancers in a general population: The SU.VI.MAX Study-design, methods, and participant characteristics. Controlled Clin Trials 1998;19:336–51.
Manson JE, Gaziano JM, Spelsberg A, Ridker PM, Cook NR, Buring JE, Willett WC, Hennekens CH, for the WACS Research Group. A secondary prevention trial of antioxidant vitamins and cardiovascular disease in women: rationale, design, and methods. Ann Epidemiol 1995;5:261–9.
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Christen, W.G., Hennekens, C.H. (2000). Antioxidant Vitamins and Cardiovascular Disease: Evidence from Observational Epidemiologic Studies and Randomized Trials. In: Tardif, JC., Bourassa, M.G. (eds) Antioxidants and Cardiovascular Disease. Developments in Cardiovascular Medicine, vol 233. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4375-2_9
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DOI: https://doi.org/10.1007/978-94-011-4375-2_9
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