Expert Opinions

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I had always heard that vitamin E is good for the heart. However, I recently read that a major study showed that vitamin E does not help prevent heart attacks. What do you make of this?

A. , S.Culver City, CA
The study you are referring to is the HOPE study conducted by a group of Canadian researchers in Hamilton, Ontario (New England Journal of Medicine, 1/20/00). The study enrolled nearly 10,000 men and women over age 55 who already had advanced cardiovascular disease or diabetes, plus one other risk factor for heart attack. Half were assigned to take 400 IU vitamin E daily, and half to a placebo. After 4 1/2 years, they found no benefit from the vitamin E.

Dr. David Edelberg comments:

I think the phrase "too little, too late," would cross our minds first. The average age of these patients was 66, which means their disease had been slowly progressing, probably since their early twenties. If at 66, you have "advanced" heart disease, we doctors would agree you're going to have to do a lot more to stop the runaway train of advancing heart disease than head over to your drugstore for a bottle of vitamin E, take one capsule daily, and expect miracles. In fact, by the time a doctor is describing you in his research project as "advanced" heart disease, consider yourself fortunate that conventional medicine and surgery has made enough progress to help bail you out.

Unless you're willing to undergo some major life styles changes, beyond dutifully taking your prescriptions (like dietary changes, exercise, stress reduction), the next few years are going to be rough for you. So really, it's not surprising that 4 1/2 years of vitamin E didn't help much. Personally, I (and a lot of cardiologists, of which I am not) started taking daily vitamin E almost 20 years ago. To the capsule of E, I added other antioxidants because they seem to work in sync with one another. The current theory on how atherosclerosis develops describes how altered oxygen molecules, called free radicals, collide with molecules of artery-clogging LDL ("bad") cholesterol. These molecules collect along your artery lining and slowly, over years, obstruct it. The antioxidant vitamins, like C, E, and the carotenes, either taken as supplements, or better yet, from a diet rich in vegetables, fruits and whole grains, have been shown to slow down this progress.

But I'm writing this and then heading over to my health club. Really, you can't be so naive to think that supplements alone are going to guarantee freedom from any illness, or measurably added years. You've got to do some of the work, too.

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