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MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20 536 high-risk individuals: a randomised placebo-controlled trial

It has been suggested that increased intake of various antioxidant vitamins reduces the incidence rates of vascular disease, cancer, and other adverse outcomes. 20 536 UK adults (aged 40–80) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive antio... Full description

Journal Title: The Lancet (British edition) 2002, Vol.360 (9326), p.23-33
Main Author: Collins, R
Other Authors: Armitage, J , Parish, S
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/12114037
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title: MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20 536 high-risk individuals: a randomised placebo-controlled trial
format: Article
creator:
  • Collins, R
  • Armitage, J
  • Parish, S
subjects:
  • Abridged Index Medicus
  • Adult
  • Aged
  • Aged, 80 and over
  • Antioxidants
  • Antioxidants - therapeutic use
  • Ascorbic Acid - blood
  • Ascorbic Acid - therapeutic use
  • Beta carotene
  • beta Carotene - blood
  • beta Carotene - therapeutic use
  • Cancer
  • Cardiovascular Diseases - mortality
  • Cardiovascular Diseases - prevention & control
  • Cause of Death
  • Cholesterol - blood
  • Coronary Disease - drug therapy
  • Diabetes Mellitus - drug therapy
  • Dietary supplements
  • Dosage and administration
  • Drug therapy
  • Female
  • Follow-Up Studies
  • Health aspects
  • Heart
  • Heart diseases
  • Humans
  • Male
  • Middle Aged
  • Neoplasms - prevention & control
  • Patient outcomes
  • Severity of Illness Index
  • Stroke - classification
  • Stroke - mortality
  • Stroke - prevention & control
  • United Kingdom
  • Vitamin C
  • Vitamin E
  • Vitamin E - blood
  • Vitamin E - therapeutic use
  • Vitamin therapy
  • Vitamins
ispartof: The Lancet (British edition), 2002, Vol.360 (9326), p.23-33
description: It has been suggested that increased intake of various antioxidant vitamins reduces the incidence rates of vascular disease, cancer, and other adverse outcomes. 20 536 UK adults (aged 40–80) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive antioxidant vitamin supplementation (600 mg vitamin E, 250 mg vitamin C, and 20 mg β-carotene daily) or matching placebo. Intention-to-treat comparisons of outcome were conducted between all vitamin-allocated and all placebo-allocated participants. An average of 83% of participants in each treatment group remained compliant during the scheduled 5-year treatment period. Allocation to this vitamin regimen approximately doubled the plasma concentration of α-tocopherol, increased that of vitamin C by one-third, and quadrupled that of β-carotene. Primary outcomes were major coronary events (for overall analyses) and fatal or non-fatal vascular events (for subcategory analyses), with subsidiary assessments of cancer and of other major morbidity. There were no significant differences in all-cause mortality (1446 [14·1%] vitamin-allocated vs 1389 [13·5%] placebo-allocated), or in deaths due to vascular (878 [8·6%] vs 840 [8·2%]) or non-vascular (568 [5·5%] vs 549 [5·3%]) causes. Nor were there any significant differences in the numbers of participants having non-fatal myocardial infarction or coronary death (1063 [10·4%] vs 1047 [10·2%]), non-fatal or fatal stroke (511 [5·0%] vs 518 [5·0%]), or coronary or non-coronary revascularisation (1058 [10·3%] vs 1086 [10·6%]). For the first occurrence of any of these “major vascular events”, there were no material differences either overall (2306 [22·5%] vs 2312 [22·5%]; event rate ratio 1·00 [95% CI 0·94–1·06]) or in any of the various subcategories considered. There were no significant effects on cancer incidence or on hospitalisation for any other non-vascular cause. Among the high-risk individuals that were studied, these antioxidant vitamins appeared to be safe. But, although this regimen increased blood vitamin concentrations substantially, it did not produce any significant reductions in the 5-year mortality from, or incidence of, any type of vascular disease, cancer, or other major outcome.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionIt has been suggested that increased intake of various antioxidant vitamins reduces the incidence rates of vascular disease, cancer, and other adverse outcomes. 20 536 UK adults (aged 40–80) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive antioxidant vitamin supplementation (600 mg vitamin E, 250 mg vitamin C, and 20 mg β-carotene daily) or matching placebo. Intention-to-treat comparisons of outcome were conducted between all vitamin-allocated and all placebo-allocated participants. An average of 83% of participants in each treatment group remained compliant during the scheduled 5-year treatment period. Allocation to this vitamin regimen approximately doubled the plasma concentration of α-tocopherol, increased that of vitamin C by one-third, and quadrupled that of β-carotene. Primary outcomes were major coronary events (for overall analyses) and fatal or non-fatal vascular events (for subcategory analyses), with subsidiary assessments of cancer and of other major morbidity. There were no significant differences in all-cause mortality (1446 [14·1%] vitamin-allocated vs 1389 [13·5%] placebo-allocated), or in deaths due to vascular (878 [8·6%] vs 840 [8·2%]) or non-vascular (568 [5·5%] vs 549 [5·3%]) causes. Nor were there any significant differences in the numbers of participants having non-fatal myocardial infarction or coronary death (1063 [10·4%] vs 1047 [10·2%]), non-fatal or fatal stroke (511 [5·0%] vs 518 [5·0%]), or coronary or non-coronary revascularisation (1058 [10·3%] vs 1086 [10·6%]). For the first occurrence of any of these “major vascular events”, there were no material differences either overall (2306 [22·5%] vs 2312 [22·5%]; event rate ratio 1·00 [95% CI 0·94–1·06]) or in any of the various subcategories considered. There were no significant effects on cancer incidence or on hospitalisation for any other non-vascular cause. Among the high-risk individuals that were studied, these antioxidant vitamins appeared to be safe. But, although this regimen increased blood vitamin concentrations substantially, it did not produce any significant reductions in the 5-year mortality from, or incidence of, any type of vascular disease, cancer, or other major outcome.
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subjectAbridged Index Medicus ; Adult ; Aged ; Aged, 80 and over ; Antioxidants ; Antioxidants - therapeutic use ; Ascorbic Acid - blood ; Ascorbic Acid - therapeutic use ; Beta carotene ; beta Carotene - blood ; beta Carotene - therapeutic use ; Cancer ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - prevention & control ; Cause of Death ; Cholesterol - blood ; Coronary Disease - drug therapy ; Diabetes Mellitus - drug therapy ; Dietary supplements ; Dosage and administration ; Drug therapy ; Female ; Follow-Up Studies ; Health aspects ; Heart ; Heart diseases ; Humans ; Male ; Middle Aged ; Neoplasms - prevention & control ; Patient outcomes ; Severity of Illness Index ; Stroke - classification ; Stroke - mortality ; Stroke - prevention & control ; United Kingdom ; Vitamin C ; Vitamin E ; Vitamin E - blood ; Vitamin E - therapeutic use ; Vitamin therapy ; Vitamins
ispartofThe Lancet (British edition), 2002, Vol.360 (9326), p.23-33
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descriptionIt has been suggested that increased intake of various antioxidant vitamins reduces the incidence rates of vascular disease, cancer, and other adverse outcomes. 20 536 UK adults (aged 40–80) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive antioxidant vitamin supplementation (600 mg vitamin E, 250 mg vitamin C, and 20 mg β-carotene daily) or matching placebo. Intention-to-treat comparisons of outcome were conducted between all vitamin-allocated and all placebo-allocated participants. An average of 83% of participants in each treatment group remained compliant during the scheduled 5-year treatment period. Allocation to this vitamin regimen approximately doubled the plasma concentration of α-tocopherol, increased that of vitamin C by one-third, and quadrupled that of β-carotene. Primary outcomes were major coronary events (for overall analyses) and fatal or non-fatal vascular events (for subcategory analyses), with subsidiary assessments of cancer and of other major morbidity. There were no significant differences in all-cause mortality (1446 [14·1%] vitamin-allocated vs 1389 [13·5%] placebo-allocated), or in deaths due to vascular (878 [8·6%] vs 840 [8·2%]) or non-vascular (568 [5·5%] vs 549 [5·3%]) causes. Nor were there any significant differences in the numbers of participants having non-fatal myocardial infarction or coronary death (1063 [10·4%] vs 1047 [10·2%]), non-fatal or fatal stroke (511 [5·0%] vs 518 [5·0%]), or coronary or non-coronary revascularisation (1058 [10·3%] vs 1086 [10·6%]). For the first occurrence of any of these “major vascular events”, there were no material differences either overall (2306 [22·5%] vs 2312 [22·5%]; event rate ratio 1·00 [95% CI 0·94–1·06]) or in any of the various subcategories considered. There were no significant effects on cancer incidence or on hospitalisation for any other non-vascular cause. Among the high-risk individuals that were studied, these antioxidant vitamins appeared to be safe. But, although this regimen increased blood vitamin concentrations substantially, it did not produce any significant reductions in the 5-year mortality from, or incidence of, any type of vascular disease, cancer, or other major outcome.
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15Cholesterol - blood
16Coronary Disease - drug therapy
17Diabetes Mellitus - drug therapy
18Dietary supplements
19Dosage and administration
20Drug therapy
21Female
22Follow-Up Studies
23Health aspects
24Heart
25Heart diseases
26Humans
27Male
28Middle Aged
29Neoplasms - prevention & control
30Patient outcomes
31Severity of Illness Index
32Stroke - classification
33Stroke - mortality
34Stroke - prevention & control
35United Kingdom
36Vitamin C
37Vitamin E
38Vitamin E - blood
39Vitamin E - therapeutic use
40Vitamin therapy
41Vitamins
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abstractIt has been suggested that increased intake of various antioxidant vitamins reduces the incidence rates of vascular disease, cancer, and other adverse outcomes. 20 536 UK adults (aged 40–80) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive antioxidant vitamin supplementation (600 mg vitamin E, 250 mg vitamin C, and 20 mg β-carotene daily) or matching placebo. Intention-to-treat comparisons of outcome were conducted between all vitamin-allocated and all placebo-allocated participants. An average of 83% of participants in each treatment group remained compliant during the scheduled 5-year treatment period. Allocation to this vitamin regimen approximately doubled the plasma concentration of α-tocopherol, increased that of vitamin C by one-third, and quadrupled that of β-carotene. Primary outcomes were major coronary events (for overall analyses) and fatal or non-fatal vascular events (for subcategory analyses), with subsidiary assessments of cancer and of other major morbidity. There were no significant differences in all-cause mortality (1446 [14·1%] vitamin-allocated vs 1389 [13·5%] placebo-allocated), or in deaths due to vascular (878 [8·6%] vs 840 [8·2%]) or non-vascular (568 [5·5%] vs 549 [5·3%]) causes. Nor were there any significant differences in the numbers of participants having non-fatal myocardial infarction or coronary death (1063 [10·4%] vs 1047 [10·2%]), non-fatal or fatal stroke (511 [5·0%] vs 518 [5·0%]), or coronary or non-coronary revascularisation (1058 [10·3%] vs 1086 [10·6%]). For the first occurrence of any of these “major vascular events”, there were no material differences either overall (2306 [22·5%] vs 2312 [22·5%]; event rate ratio 1·00 [95% CI 0·94–1·06]) or in any of the various subcategories considered. There were no significant effects on cancer incidence or on hospitalisation for any other non-vascular cause. Among the high-risk individuals that were studied, these antioxidant vitamins appeared to be safe. But, although this regimen increased blood vitamin concentrations substantially, it did not produce any significant reductions in the 5-year mortality from, or incidence of, any type of vascular disease, cancer, or other major outcome.
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pmid12114037
doi10.1016/S0140-6736(02)09328-5