In recent years, vitamin E has been investigated as a cardioprotective agent. 
Experimental studies have identified potential mechanisms by which vitamin E may 
inhibit the development of atherosclerosis, and observational studies of 
individuals without coronary disease suggest that vitamin E intake may prevent 
future cardiovascular events. Secondary prevention trials to date have 
demonstrated little benefit from vitamin E supplementation. It remains possible, 
however, that supplementation may be useful among certain high-risk groups, 
including those with nutritional deficiencies. Limited data from completed 
primary prevention trials also indicate minimal cardioprotection from vitamin E, 
but large-scale trials now in progress may yet show benefit. Results from 
ongoing trials will contribute powerfully to the totality of evidence on which 
to formulate both appropriate clinical recommendations for individual patients 
and a rational public health policy for the population as a whole. At this time, 
there is insufficient evidence for issuing a public health recommendation to use 
vitamin E supplements to prevent cardiovascular disease (CVD). Rather, increased 
intake of fruits, vegetables, and other antioxidant-rich foods should be 
promoted as part of a healthy diet because they provide nutritional benefits 
beyond any potential antioxidant effect. Moreover, even if found to reduce CVD 
risk, vitamin supplement use should be considered an adjunct, not an 
alternative, to established cardioprotective measures, such as smoking 
abstention, avoidance of obesity, adequate physical activity, and control of 
high blood pressure and hyperlipidemia.