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Vitamin E did not reduce myocardial infarction, death, or stroke in adults at high risk for cardiovascular events

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 QUESTION: In adults who have a high risk for cardiovascular events, do vitamin E supplements improve cardiovascular outcomes?


Randomised {allocation concealed*}, blinded {patients, clinicians, and outcome assessors},* placebo controlled trial with a 2 × 2 factorial design and a mean follow up of 4.5 years (Heart Outcomes Prevention Evaluation [HOPE] study).


{161 centers in North America, 76 in 14 western European countries, and 30 in Argentina and Brazil.}


9541 patients (mean age 66 y, 73% men) who were {≥55 years of age and had a history of coronary artery disease, stroke, peripheral vascular disease, or diabetes and ≥1 other cardiovascular disease risk factor. Exclusion criteria were heart failure, ejection …

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  • Sources of funding: Medical Research Council of Canada; Natural Source Vitamin E Association; Negma; Hoechst-Marion Roussel; AstraZeneca; King Pharmaceuticals; Heart and Stroke Foundation of Ontario.

  • For correspondence:Dr S Yusuf, Canadian Cardiovascular Collaboration Project Office, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada. Fax +1 905 521 1166.

  • * See glossary.

  • The HOPE Study Investigators. Can J Cardiol 1996;12:127–37.

  • The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000;342:145–53.