Scientific Study

BACKGROUND: The role of dietary antioxidant vitamins in preventing coronary heart disease has aroused considerable interest because of the knowledge that oxidative modification of low-density lipoprotein may promote atherosclerosis. METHODS. We studied 34;486 postmenopausal women with no cardiovascular disease who in early 1986 completed a questionnaire that assessed; among other factors; their intake of vitamins A; E; and C from food sources and supplements. During approximately seven years of follow-up (ending December 31; 1992); 242 of the women died of coronary heart disease. RESULTS. In analyses adjusted for age and dietary energy intake; vitamin E consumption appeared to be inversely associated with the risk of death from coronary heart disease. This association was particularly striking in the subgroup of 21;809 women who did not consume vitamin supplements (relative risks from lowest to highest quintile of vitamin E intake; 1.0; 0.68; 0.71; 0.42; and 0.42; P for trend 0.008). After adjustment for possible confounding variables; this inverse association remained (relative risks from lowest to highest quintile; 1.0; 0.70; 0.76; 0.32; and 0.38; P for trend; 0.004). There was little evidence that the intake of vitamin E from supplements was associated with a decreased risk of death from coronary heart disease; but the effects of high-dose supplementation and the duration of supplement use could not be definitely addressed. Intake of vitamins A and C did not appear to be associated with the risk of death form coronary heart disease. CONCLUSIONS. These results suggest that in postmenopausal women the intake of vitamin E from food is inversely associated with the risk of death from coronary heart disease and that such women can lower their risk without using vitamin supplements. By contrast; the intake of vitamins A and C was not associated with lower risks of dying from coronary disease.