Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease
Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease
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DOI：
10.1001/archinte.164.14.1552
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发表时间：
2004-07-26
影响因子：
--
通讯作者：
Hennekens, CH
中科院分区：
文献类型：
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作者：
Eidelman, RS;Hollar, D;Hennekens, CH
背景资料：观察性流行病学研究一致表明，选择通过饮食或补充剂摄入大量维生素E的人会体验心血管益处，基础研究提供了合理的机制。然而，由于假设的获益大小是小到中等，因此混淆。观察性研究中固有的效应与效应大小一样大。在随机证据的可用性，约1/4的成年人服用维生素E补充剂在UnitedStates.Methods：我们进行了计算机检索的英文文献从1990年到现在，发现7个大规模的随机试验的有效性维生素E在治疗和预防心血管疾病。数据可用于心肌梗死，中风，或心血管death.Results：6的7项试验显示，维生素E对心血管疾病没有显着影响。总的来说，维生素E对任何重要的心血管事件既没有统计学意义，也没有临床重要影响（比值比[OR]，0.98; 95%置信区间[CI]，0.94-1.03）或其组分：非致死性心肌梗死（OR，1.00; 95% CI，0.92-1.09），非致死性卒中（OR，1.03; 95% CI，0.93-1.14）或心血管死亡（OR，1.00; 95%CI，0.94-1.05）。OR和CI为维生素E对心血管疾病缺乏统计学显著性或临床重要性的影响提供了强有力的支持。使用经证明缺乏益处的药物，特别是那些容易在柜台上获得的药物，可能会导致经证明有益的药物使用不足，以及未能采取健康的生活方式。
Background: Observational epidemiological studies consistently show that individuals who choose to take high amounts of vitamin E through diet or supplements experience cardiovascular benefits, for which basic research provides plausible mechanisms. However, because the size of the postulated benefit is small to moderate, the confounding. inherent in observational studies is as great as the effect size. Before the availability of randomized evidence, about 1 in 4 adults was taking vitamin E supplements in the United States.Methods: We conducted a computerized search of the English-language literature from 1990 to the present and found 7 large-scale randomized trials of the effectiveness vitamin E in the treatment and prevention of cardiovascular disease. Data were available on myocardial infarction, stroke, or cardiovascular death.Results: Six of the 7 trials showed no significant effect of vitamin E on cardiovascular disease. In an overview, vitamin E had neither a statistically significant nor a clinically important effect on any important cardiovascular event (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.94-1.03) or its components: nonfatal myocardial infarction (OR, 1.00; 95% CI, 0.92-1.09), nonfatal stroke (OR, 1.03; 95% CI, 0.93-1.14), or cardiovascular death (OR, 1.00; 95% CI, 0.94-1.05).Conclusions: The ORs and CIs provide strong support for a lack of statistically significant or clinically important effects of vitamin E on cardiovascular disease. The use of agents of proven lack of benefit, especially those easily available over the counter, may contribute to underuse of agents of proven benefit and failure to adopt healthy lifestyles.