Is there a vitamin E paradox?

In addition to epidemiologic studies that suggest a benefit for high intake s of alpha -tocopherol, studies of supplementation in humans have clearly s hown that alpha -tocopherol decreases lipid peroxidation, platelet aggregat ion, and functions as a potent anti-inflammatory agent. In the five large p rospective clinical trials with x-tocopherol therapy, four have shown a ben eficial effect on cardiovascular end-points (two studies on a primary end-p oint and two studies on other cardiovascular end-points). Thus, the totalit y of evidence based on the epidemiologic data, in-vitro studies and animal models, and the clinical trials appears to support a benefit for alpha -toc opherol supplementation in patients with pre-existing cardiovascular diseas e. However, definitive recommendations must await ongoing clinical trials. Curr Opin Lipidol 12:49-53. (C) 2001 Lippincott Williams & Wilkins.