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Original Article
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Volume 334:1156-1162
May 2, 1996

Number 18
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Dietary Antioxidant Vitamins and Death from Coronary Heart Disease in
Postmenopausal Women
Lawrence H. Kushi, Sc.D., Aaron R. Folsom, M.D., Ronald J. Prineas,
M.B., B.S., Pamela J. Mink, M.P.H., Ying Wu, M.P.H., and Roberd M.
Bostick, M.D.
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ABSTRACT
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 definitively
addressed. Intake of vitamins A and C did not appear to be associated
with the risk of death from 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.
Source Information

From the Division of Epidemiology, University of Minnesota School of
Public Health, Minneapolis (L.H.K., A.R.F., P.J.M.); the Department of
Epidemiology and Public Health, University of Miami, Miami (R.J.P.);
the Department of Epidemiology, University of Pittsburgh, Pittsburgh
(Y.W.); and the Bowman Gray School of Medicine, Wake Forest
University, Winston-Salem, N.C. (R.M.B.).
Address reprint requests to Dr. Kushi at the Division of Epidemiology,
University of Minnesota School of Public Health, 1300 S. Second St.,
Suite 300, Minneapolis, MN 55454-1015.

Full Text of this Article
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Extract  Full Text
N Engl J Med 1996; 335:1065-1069, Oct 3, 1996. Correspondence
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