Supplemental Vitamin E Shown No Benefit In Patients With Advanced Heart Failure - Brief Article

Nutrition Research Newsletter, Feb, 2001

Recently, it has been established that oxidative stress is increased in individuals suffering from congestive heart failure (CHF). This stress contributes to the progressive deterioration in CHF patients, which ultimately leads to death. It is thought that the increased stress results from either an increase in production of damaging free radicals or a depletion of endogenous antioxidants, including vitamin E. Epidemiologic evidence shows an inverse relation between vitamin E intake and risk of coronary artery disease. However, there is very limited data regarding vitamin E supplementation in advanced heart failure.

A controlled clinical trial was initiated to investigate whether vitamin E supplementation of individuals with advanced CHF modifies measures of oxidative and neurohormonal stress and results in improved quality of life. Fifty-six individuals with advanced heart failure enrolled in a double-blind randomized controlled trial for 12 weeks. Patients were eligible for the study if they were classified as having disease of New York Heart Association functional class III or IV and had not taken any multivitamin supplements containing greater than 10 mg of vitamin E per day. The subjects were seen at three different visits. At each visit subjects provided medical history, and height, weight, and blood pressure were measured. Blood was collected for baseline measure of electrolytes, liver and kidney function, and indexes of oxidative stress. Breath samples were collected for the analysis of thane and pentane. Subjects' quality of life was assessed using the University of Minnesota Living with Heart Failure questionnaire at baseline and at 12 weeks. Following collection of baseline information, subjects were randomized to receive either 500 IU of RRR-a tocopherol or placebo. Subjects were instructed to take the two supplements or two placebos daily.

Subjects taking the supplemental vitamin E were found to have significantly increased plasma concentrations of atocopherol when compared to the placebo group. However, the treatment failed to result in any other significant affect of any other marker of oxidative stress or quality of life.

It can be concluded that supplementation with vitamin E in individuals with advanced congestive heart failure yields no benefit in terms of oxidative stress or quality of life.

M. Keith, K. Jeejeebhoy, A. Langer, et al. A controlled clinical trial of vitamin E supplementation in patients with congestive heart failure. Am J Clin Nutr 73:219-224 (February 2001) [Correspondence: M.J. Sole, 212-A13-Eaton North, Toronto General Hospital, 200 Elizabeth St., Toronto, ON M5G-2C4, Canada. E-mail: Michael.sole@uhn.on.ca].

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