From: Subject: JAMA -- Abstract: Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer: The Women's Health Study: A Randomized Controlled Trial, July 6, 2005, Lee et al. 294 (1): 56 Date: Thu, 20 Jul 2006 17:23:43 +0200 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0139_01C6AC21.4054DF00" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.2869 This is a multi-part message in MIME format. ------=_NextPart_000_0139_01C6AC21.4054DF00 Content-Type: text/html; charset="Windows-1252" Content-Transfer-Encoding: quoted-printable Content-Location: http://jama.ama-assn.org/cgi/content/abstract/294/1/56?ijkey=4056fd8ea7e49ae97ddd86b1915b996422310dc4&keytype2=tf_ipsecsha JAMA -- Abstract: Vitamin E in the Primary Prevention = of Cardiovascular Disease and Cancer: The Women's Health Study: A = Randomized Controlled Trial, July 6, 2005, Lee et al. 294 (1): = 56

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JAMA-EXPRESS
Vitamin E in the Primary Prevention of = Cardiovascular=20 Disease and Cancer

The Women=92s Health Study: A Randomized = Controlled=20 Trial

I-Min Lee, MBBS, ScD; Nancy R. = Cook,=20 ScD; J. Michael Gaziano, MD; David = Gordon,=20 MA; Paul M Ridker, MD; JoAnn E. = Manson,=20 MD, DrPH; Charles H. Hennekens, MD, = DrPH;=20 Julie E. Buring, ScD

JAMA. 2005;294:56-65.

Context  Basic research provides = plausible=20 mechanisms and observational studies suggest that = apparently healthy persons, who self-select for = high=20 intakes of vitamin E through diet or supplements, = have=20 decreased risks of cardiovascular disease and = cancer.=20 Randomized trials do not generally support benefits = of=20 vitamin E, but there are few trials of long duration = among=20 initially healthy persons.

Objective  To test whether vitamin E = supplementation=20 decreases risks of cardiovascular disease and = cancer=20 among healthy women.

Design, Setting, and Participants  In the=20 Women=92s Health Study conducted between 1992 and = 2004,=20 39 876 apparently healthy US women aged at = least 45=20 years were randomly assigned to receive vitamin E = or=20 placebo and aspirin or placebo, using a = 2 x 2 factorial design, and = were=20 followed up for an average of 10.1 years. =

Intervention  Administration of 600 IU of=20 natural-source vitamin E on alternate days. =

Main Outcome Measures  Primary outcomes were = a=20 composite end point of first major cardiovascular = event=20 (nonfatal myocardial infarction, nonfatal stroke, = or=20 cardiovascular death) and total invasive = cancer.=20

Results  During follow-up, there were 482 = major=20 cardiovascular events in the vitamin E group and = 517 in=20 the placebo group, a nonsignificant 7% risk = reduction=20 (relative risk [RR], 0.93; 95% confidence = interval=20 [CI], 0.82-1.05; P =3D .26). = There were no=20 significant effects on the incidences of myocardial=20 infarction (RR,  1.01; 95% CI, 0.82-1.23;=20 P =3D .96) or stroke = (RR, 0.98; 95%=20 CI, 0.82-1.17; P =3D .82), as = well as=20 ischemic or hemorrhagic stroke. For cardiovascular = death,=20 there was a significant 24% reduction (RR, 0.76; 95% = CI,=20 0.59-0.98; P =3D .03). There was no = significant=20 effect on the incidences of total cancer (1437 cases = in=20 the vitamin E group and 1428 in the placebo = group; RR,=20 1.01; 95% CI, 0.94-1.08; = P =3D .87) or=20 breast (RR, 1.00; 95% CI, 0.90-1.12;=20 P =3D .95), lung (RR, 1.09; 95% CI, = 0.83-1.44;=20 P =3D .52), or colon cancers (RR, = 1.00; 95% CI,=20 0.77-1.31; P =3D .99). Cancer = deaths also=20 did not differ significantly between groups. = There was no=20 significant effect of vitamin E on total = mortality (636=20 in the vitamin E group and 615 in the placebo = group; RR,=20 1.04; 95% CI, 0.93-1.16; P =3D .53). =

Conclusions  The data from this large trial = indicated=20 that 600 IU of natural-source vitamin E taken = every other=20 day provided no overall benefit for major = cardiovascular=20 events or cancer, did not affect total mortality, = and=20 decreased cardiovascular mortality in healthy=20 women. These data do not support recommending=20 vitamin E supplementation for cardiovascular disease = or=20 cancer prevention among healthy women. =


Author=20 Affiliations: Divisions of Preventive Medicine (Drs Lee, = Cook,=20 Gaziano, Ridker, Manson, and Buring and Mr Gordon), = Cardiovascular=20 Medicine (Drs Gaziano and Ridker), and Aging (Drs Gaziano = and=20 Buring), Department of Medicine, Brigham and Women=92s = Hospital,=20 Harvard Medical School, Boston, Mass; Department of = Epidemiology,=20 Harvard School of Public Health, Boston (Drs Lee, Cook, = Ridker,=20 Manson, and Buring); Veterans Affairs Boston Healthcare = System (Dr=20 Gaziano); Department of Ambulatory Care and Prevention, = Harvard=20 Medical School, Boston (Dr Buring); and the Departments of = Medicine=20 and Epidemiology and Public Health, University of Miami = School of=20 Medicine, Miami, Fla, and Department of Biomedical Science, = Center=20 of Excellence, Florida Atlantic University, Boca Raton (Dr=20 Hennekens).


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