Vitamin E Atherosclerosis Prevention Study - VEAPS

Dec 18, 2003
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Date Presented:
01/01/2002
Date Published:
01/01/2002
Date Updated:
12/18/2003
Original Posted Date:
12/18/2003
References

Description:

The goal of this study was to determine whether administration of supplemental vitamin E is associated with the development of carotid artery (CA) atherosclerosis in healthy adults. Observational studies suggest a benefit of vitamin E for coronary risk reduction in healthy persons, a finding not supported by controlled trials.

Study Design

Study Design:

Patients Enrolled: 353
Mean Patient Age: 40-82
Female: 52

Drug/Procedures Used:

353 men and women > 40 yrs with an LDL-C > 130mg/dl and no clinical CVD were randomized to 400 IU of alpha-tocopherol Vs placebo. Carotid ultrasound was used to measure far wall right CA intima-media thickness (IMT) every six months. Randomization was further stratified by a baseline IMT below or equal to and above 0.75 mm. Exclusion criteria included diabetes, fasting triglycerides >500 mg/dl, regular vitamin E use, diastolic BP > 100 mmHg, and > 5 alcohol drinks daily.

Principal Findings:

The mean age was 56 years (range 40-82 years) and 48% were male. 318 subjects completed 2 years and 258 participated in a 3rd year recommended by the data-safety monitoring committee. There was no difference between treatment groups regarding baseline IMT, or any laboratory or clinical parameters. Baseline IMT was similar between groups (mean 0.76 mm). There was no difference in average rates of progression of IMT overall or after adjusting for baseline LDL-C or gender. Supplemental vitamin E raised the plasma vitamin E and reduced the oxidized LDL and LDL oxidation susceptibility. There was no treatment effect on clinical outcome.

Interpretation:

Among healthy patients, supplemental vitamin E was associated with no benefits in reduction of carotid artery atherosclerosis. The results of the many studies evaluating antioxidants for primary and secondary prevention in CVD remain inconclusive, but there is no support for vitamin E supplement alone. Plasma markers of LDL oxidation did not correlate with disease progression suggesting tissue effects are more important. Vitamin E may be pro-oxidant in tissues and has been shown to increase coronary disease progression and clinical events in CAD with relatively low HDL-C.

References:

Hodis HN, Mack WJ, LaBree L, et al for the VEAPS Research Group. Alpha-Tocopherol Supplementation in Healthy Individuals Reduces Low-Density Lipoprotein Oxidation but Not Atherosclerosis. The Vitamin E Atherosclerosis Prevention Study (VEAPS). Circulation 2002;106:1453-59.

Keywords: Reactive Oxygen Species, Atherosclerosis, Vitamin E, Risk Reduction Behavior, Carotid Artery Diseases, Lipoproteins, LDL, alpha-Tocopherol, Triglycerides, Diabetes Mellitus, Fasting, Disease Progression


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