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Cardiovascular and Metabolic Protection by Vitamin E: A Matter of Treatment Strategy?
Melanie Ziegler1, Maria Wallert2,3, Stefan Lorkowski2,3
1Department of Cardiology and Angiology, Internal Medicine III, University Clinic of Tübingen, 72076 Tübingen, Germany.
Insights
Vitamin E supplementation has yielded disappointing results for cardiovascular disease prevention. Acute vitamin E therapy, particularly for myocardial infarction, shows promise by addressing deficiency during severe oxidative stress.
Area of Science:
- Biochemistry
- Cardiology
- Nutritional Science
Background:
- Cardiovascular diseases (CVD) represent a leading cause of global mortality.
- Vitamin E, known for antioxidant and anti-inflammatory effects, has been investigated for CVD prevention.
- Previous studies on vitamin E for CVD prevention yielded conflicting results.
Purpose of the Study:
- To re-evaluate the role of vitamin E in cardiovascular health.
- To explore the potential of acute vitamin E administration versus chronic supplementation.
Main Methods:
- Review of existing randomized controlled trials and clinical findings.
- Analysis of factors influencing vitamin E efficacy, including study design, patient characteristics, and genetic variations.
- Investigation of vitamin E levels in patients with myocardial infarction (MI).
Main Results:
- Chronic vitamin E supplementation trials showed disappointing outcomes in reducing cardiovascular events.
- Factors such as study design, patient selection, and comorbidities influenced trial results.
- Acute vitamin E deficiency is observed in myocardial infarction patients, suggesting a potential therapeutic window.
Conclusions:
- Chronic vitamin E supplementation may not be effective for long-term CVD prevention due to insufficient antagonism of oxidative and inflammatory status.
- Acute, short-term administration of vitamin E, especially in conditions like MI, shows promising results.
- Revisiting vitamin E therapy with an acute treatment approach may offer clinical benefits for cardiovascular events.
Abstract:
Cardiovascular diseases (CVD) cause about 1/3 of global deaths. Therefore, new strategies for the prevention and treatment of cardiovascular events are highly sought-after. Vitamin E is known for significant antioxidative and anti-inflammatory properties, and has been studied in the prevention of CVD, supported by findings that vitamin E deficiency is associated with increased risk of cardiovascular events. However, randomized controlled trials in humans reveal conflicting and ultimately disappointing results regarding the reduction of cardiovascular events with vitamin E supplementation. As we discuss in detail, this outcome is strongly affected by study design, cohort selection, co-morbidities, genetic variations, age, and gender. For effective chronic primary and secondary prevention by vitamin E, oxidative and inflammatory status might not have been sufficiently antagonized. In contrast, acute administration of vitamin E may be more translatable into positive clinical outcomes. In patients with myocardial infarction (MI), which is associated with severe oxidative and inflammatory reactions, decreased plasma levels of vitamin E have been found. The offsetting of this acute vitamin E deficiency via short-term treatment in MI has shown promising results, and, thus, acute medication, rather than chronic supplementation, with vitamin E might revitalize vitamin E therapy and even provide positive clinical outcomes.
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