The American Journal of Medicine
Volume 120, Issue 2 , Pages 180-184, February 2007

Risk of Mortality with Vitamin E Supplements: The Cache County Study

  • Kathleen M. Hayden, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
    • Corresponding Author InformationRequests for reprints should be addressed to Kathleen M. Hayden, PhD, 2200 West Main St, Suite A-200, Durham, NC 27705.
    • ,
  • Kathleen A. Welsh-Bohmer, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
    • ,
  • Heidi J. Wengreen, PhD

      Affiliations

    • Department of Nutrition and Food Sciences, Utah State University, Logan, Utah
    • Center for Epidemiologic Studies, Utah State University, Logan, Utah
    • ,
  • Peter P. Zandi, PhD

      Affiliations

    • Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
    • ,
  • Constantine G. Lyketsos, MD, MHS

      Affiliations

    • Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
    • Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, The Johns Hopkins University School of Medicine, Baltimore, Md
    • ,
  • John C.S. Breitner, MD, MPH

      Affiliations

    • VA Puget Sound Health Care System, Seattle, Wash
    • Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Wash.
    • ,
  • Cache County Investigators

Abstract 

Purpose

A recent meta-analysis reported increased mortality in clinical trial participants randomized to high-dose vitamin E. We sought to determine whether these mortality risks with vitamin E reflect adverse consequences of its use in the presence of cardiovascular disease.

Methods

In a defined population aged 65 years or older, baseline interviews captured self- or proxy-reported history of cardiovascular illness. A medicine cabinet inventory verified nutritional supplement and medication use. Three sources identified subsequent deaths. Cox proportional hazards methods examined the association between vitamin E use and mortality.

Results

After adjustment for age and sex, there was no association in this population between vitamin E use and mortality (adjusted hazard ratio [aHR] 0.93; 95% confidence interval [CI], 0.74-1.15). Predictably, deaths were more frequent with a history of diabetes, stroke, coronary artery bypass graft surgery, or myocardial infarction, and with the use of warfarin, nitrates, or diuretics. None of these conditions or treatments altered the null main effect with vitamin E, but mortality was increased in vitamin E users who had a history of stroke (aHR 3.64; CI, 1.73-7.68), coronary bypass graft surgery (aHR 4.40; CI, 2.83-6.83), or myocardial infarction (aHR 1.95; CI, 1.29-2.95) and, independently, in those taking nitrates (aHR 3.95; CI, 2.04-7.65), warfarin (aHR 3.71; CI, 2.22-6.21), or diuretics (aHR 1.83; CI, 1.35-2.49). Although not definitive, a consistent trend toward reduced mortality was seen in vitamin E users without these conditions or treatments.

Conclusions

In this population-based study, vitamin E use was unrelated to mortality, but this apparently null finding seems to represent a combination of increased mortality in those with severe cardiovascular disease and a possible protective effect in those without.

Keywords: Vitamin E, Mortality, Cardiovascular disease, Cohort study, Proportional hazards, Survival analysis

 

 This work was supported by National Institute on Aging grant AG-11380 and the work of Dr Hayden by T32-AG00029.

PII: S0002-9343(06)00575-4

doi:10.1016/j.amjmed.2006.03.039

The American Journal of Medicine
Volume 120, Issue 2 , Pages 180-184, February 2007

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