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To the Editor: In 1950, Vogelsang¹ reported that intramuscular administration of -tocopherol produced rapid and dramatic diuresis in patients with severe heart failure. Dr Lonn and colleagues have now shown that long-term supplementation with -tocopherol increases the risk of developing heart failure.² These findings are not necessarily incompatible.

Vitamin E occurs in food in 4 different forms (-, -, -, and -tocopherol), but most of the clinical research has been performed with -tocopherol alone. Although early research suggested that most of the biological activity of vitamin E resides in the -fraction, -tocopherol has certain effects that might help prevent cardiovascular disease. Platelet aggregation and the formation of nitric-oxide–derived oxidants are inhibited to a greater extent by -tocopherol than by -tocopherol.³ Treatment with large doses of -tocopherol reduces serum concentrations of -tocopherol (apparently by accelerating its metabolism),⁴ and could thereby interfere with these effects.

-Tocopherol comprises 70% of the vitamin . . . [Full Text of this Article]

Alan R. Gaby, MD
drgaby@earthlink.net
Carlisle, Pa

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