Authors' objectives:

This report aims to establish evidence-based guidelines for the use of vitamin E in the prevention of cardiovascular disease (CVD) and cancer.

Authors' results and conclusions: Benefits, Harms, and Costs: No studies have shown a significantly reduced overall mortality associated with vitamin E use. No trials have found a benefit from vitamin E in reducing cardiovascular disease in either the primary or secondary prevention setting, but are limited by key internal study design flaws and generalizability. One of five trials found a reduction of CVD death and non-fatal myocardial infarction (RR= O.53, 95% CI 0.34-0.83) from vitamin E in the secondary prevention of coronary events in patients with established cardiovascular disease. The other cardiovascular endpoints were not reduced. Two good quality RCTs have not shown a reduction in lung cancer, and 2 studies of vitamin supplementation have not demonstrated benefit in cancer reduction for a number of cancer outcomes. In general, vitamin E was well tolerated with no significant adverse effects in the large RCTs reported in this review, with the exception of a trend toward increased risk of hemorrhagic stroke and increased risk of cardiovascular mortality seen in small trials. Values: The strength of evidence was evaluated using the methods of the Canadian Task Force on Preventive Health Care.

Authors' recommendations: There is insufficient evidence to recommend for or against the use of routine vitamin E supplementation for the primary prevention of CVD events in the general population and in male smokers (I Recommendation). The Task Force concludes that there is good evidence to recommend against the use of routine vitamin E supplementation for the secondary prevention of CVD in patients with established CVD or risk factors for CVD (D Recommendation). There is good evidence to recommend against the use of routine vitamin E supplementation for the prevention of lung cancer (D Recommendation). The Task Force concludes that there is insufficient evidence to recommend for or against the use of routine vitamin E supplementation for the prevention of cancers other than lung cancer (esophageal, stomach, colorectal, urological, and prostate) in the general population (I Recommendation).

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ctfphc.org/Full_Text/CTF_VitE_TR_final_19Mar04.pdf

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Task Force on Preventive Health Care

Contact Address: Canadian Task Force on Preventive Health Care, 100 Collip Circle, Suite 117, London, ON, N6G 4X8, Canada. Tel: 519-858-5181; Fax: 519-858-5112

Contact Name: ctf@ctfphc.org

Contact Email: ctf@ctfphc.org

Copyright: Canadian Task Force on Preventive Health Care (CTFPHC)