Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly

Abstract

We examined vitamin E and vitamin C supplement use in relation to mortality risk and whether vitamin C enhanced the effects of vitamin E in 11,178 persons aged 67-105 y who participated in the Established Populations for Epidemiologic Studies of the Elderly in 1984-1993. Participants were asked to report all nonprescription drugs currently used, including vitamin supplements. Persons were defined as users of these supplements if they reported individual vitamin E and/or vitamin C use, not part of a multivitamin. During the follow-up period there were 3490 deaths. Use of vitamin E reduced the risk of all-cause mortality [relative risk (RR) = 0.66; 95% CI: 0.53, 0.83] and risk of coronary disease mortality (RR = 0.53; 95% CI: 0.34, 0.84). Use of vitamin E at two points in time was also associated with reduced risk of total mortality compared with that in persons who did not use any vitamin supplements. Effects were strongest for coronary heart disease mortality (RR = 0.37; 95% CI: 0.15, 0.90). The RR for cancer mortality was 0.41 (95% CI: 0.15, 1.08). Simultaneous use of vitamins E and C was associated with a lower risk of total mortality (RR = 0.58; 95% CI: 0.42, 0.79) and coronary mortality (RR = 0.47; 95% CI: 0.25, 0.87). Adjustment for alcohol use, smoking history, aspirin use, and medical conditions did not substantially alter these findings. These findings are consistent with those for younger persons and suggest protective effects of vitamin E supplements in the elderly.

An In-vitro study of Lipid peroxidation, Vitamin E and Vitamin C levels in saliva of oral precancerous patients in Distt Hapur of U.P.

“…18 Use of vitamin E supplementation reduces the risk of mortality (due to any cause) by 34% and risk of heart disease mortality by 47-63% and cancer risk by 59% as compared to those who are not using vitamin E supplements. 19 Vitamin E supplementation has shown favorable influence on different prostaglandins made by the body. Prostaglandins effects inflammatory response and immune system and also prevent heart disease and cancer.…”

Micronutrient Vitamin Deficiencies and Cardiovascular Disease Risk: Advancing Current Understanding

“…Nevertheless, some other epidemiologic prospective studies found the converse, including the Multiple Risk Factor Intervention Trial, the Elderly Cohort Studies [154], the Rotterdam Study [155], the European Community Multicenter Study on Antioxidants, and the Gruppo Italiano per lo Studio della Sopravvivenza nell Infarto Miocardico prevention trial [156]. The lack of observed association in these studies may be attributable to uncontrolled confounding from unknown or unmeasured confounders such as exercise, diet, concurrent vitamin C depletion or deficiency, and background CVD risk of different study populations.…”

“…Similarly, the cardio-protective effect of vitamin E is enhanced and sustained when co-administered with vitamin C [154] due to the synergistic antioxidant effect of both vitamins. The antioxidant activity of alpha-tocopherol results in the production of toxic tocopherol radicals, which are reconverted into alpha-tocopherol by vitamin C and are then reutilized ( Figure 6).…”

Adverse effects of vitamin E by induction of drug metabolism

“…In a Finnish study [40] dietary vitamin E consumption was linked to a reduction in CVD mortality. The Established Populations for Epidemiologic Studies of the Elderly reported a decrease in mortality in particular due to coronary artery disease in elderly people taking vitamin E supplements [51]. As an exception, the Rotterdam study [38] did not reveal a beneficial effect of vitamin E on myocardial infarction.…”