OBJECTIVE: To evaluate the effects of alpha tocopherol and beta carotene 
supplements on recurrence and progression of angina symptoms, and incidence of 
major coronary events in men with angina pectoris.
DESIGN: Placebo controlled clinical trial.
SETTING: The Finnish alpha tocopherol beta carotene cancer prevention study 
primarily undertaken to examine the effects of alpha tocopherol and beta 
carotene on cancer.
SUBJECTS: Male smokers aged 50-69 years who had angina pectoris in the Rose 
chest pain questionnaire at baseline (n = 1795).
INTERVENTIONS: alpha tocopherol (vitamin E) 50 mg/day, beta carotene 20 mg/day 
or both, or placebo in 2 x 2 factorial design.
MAIN OUTCOME MEASURES: Recurrence of angina pectoris at annual follow up visits 
when the questionnaire was readministered; progression from mild to severe 
angina; incidence of major coronary events (non-fatal myocardial infarction and 
fatal coronary heart disease).
RESULTS: There were 2513 recurrences of angina pectoris during follow up (median 
4 years). Compared to placebo, the odds ratios for recurrence in the active 
treatment groups were: alpha tocopherol only 1.06 (95% confidence interval (CI) 
0.85 to 1.33), alpha tocopherol and beta carotene 1.02 (0.82 to 1.27), beta 
carotene only 1.06 (0.84 to 1.33). There were no significant differences in 
progression to severe angina among the groups given supplements or placebo. 
Altogether 314 major coronary events were observed during follow up (median 5.5 
years) and the risk for them did not differ significantly among the groups given 
supplements or placebo.
CONCLUSIONS: There was no evidence of beneficial effects for alpha tocopherol or 
beta carotene supplements in male smokers with angina pectoris, indicating no 
basis for therapeutic or preventive use of these agents in such patients.