Therapeutic ReviewVitamin E and Cardiovascular DiseaseSaremi, Adonis MS; Arora, Rohit MD, FACC*Author Information From the Department of Medicine, Chicago Medical School, North Chicago, IL. *Address for correspondence: Chicago Medical School, Department of Cardiology, 3001 Green Bay Road, North Chicago VA Medical Center-133B, North Chicago, IL 60064. E-mail: [email protected] American Journal of Therapeutics: May 2010 - Volume 17 - Issue 3 - p e56-e65 doi: 10.1097/MJT.0b013e31819cdc9a Buy Metrics Abstract The objective of this article is to review the role of vitamin E in cardiovascular disease. We begin by describing the general characteristics and metabolism of vitamin E and the pathogenesis of atherosclerosis as it relates to oxidation. We also discuss key in vitro studies, animal studies, observational studies, and clinical trials regarding the potentially cardioprotective effect of vitamin E. Lastly, we outline the current recommendations regarding vitamin E in the prevention and treatment of cardiovascular disease as stated by the American Heart Association. Vitamin E is a fat-soluble antioxidant vitamin and alpha-tocopherol is its most naturally abundant and active form. Oxidation is a key step in atherogenesis. Oxidized low-density lipoprotein stimulates endothelial cells to produce inflammatory markers, is involved in foam cell formation, has cytotoxic effects on endothelial cells, inhibits the motility of tissue macrophages, and inhibits nitric oxide-induced vasodilatation. Vitamin E has been shown to increase oxidative resistance in vitro and prevent atherosclerotic plaque formation in mouse models. Consumption of foods rich in vitamin E has been associated with lower risk of coronary heart disease in middle-aged to older men and women. Clinical studies at large have not demonstrated a benefit of vitamin E in the primary and secondary prevention of cardiovascular disease. Vitamin E supplementation might be associated with an increase in total mortality, heart failure, and hemorrhagic stroke. The American Heart Association does not support the use of vitamin E supplements to prevent cardiovascular disease, but does recommend the consumption of foods abundant in antioxidant vitamins and other nutrients. © 2010 Lippincott Williams & Wilkins, Inc.