Inverse correlation of vitamin E and ischemic heart disease.

According to animal experiments, deficiency in vitamin E may be related to arterial lesions. In current cross-cultural epidemiology of middle-aged men representing 11 European populations with different mortality from ischemic heart disease (IHD) all principal antioxidant vitamins and selenium were compared in plasma. The vitamin E concentration within lipoproteins (alpha-tocopherol/cholesterol ratio) showed the most prominent correlation with IHD. This highly significant correlation seemed to be independent of the risk of coronary mortality attributable to hypercholesterolemia. The levels of lipid-standardized vitamin E associated with a relatively higher IHD risk were still in a range which has hitherto been considered "normal." The differences between individuals of lipid-standardized plasma vitamin E were reflected by corresponding changes of vitamin E in the erythrocyte and buccal mucosa. On the other hand, membrane vitamin E varied independently from the level of polyunsaturated fatty acids (PUFAs) in the membrane. The present data suggest that the plasma level of lipid-standardized vitamin E is a hitherto underrated risk factor of IHD which may substantially complement previously known risk factors, such as hypercholesterolemia and a critical state of PUFAs. A conceivable preventive effect of (an enlarged RDA of) vitamin E remains to be elucidated by an intervention trial.