A Time to Stop Prescribing Antioxidant Vitamins to Prevent and Treat Heart Disease?

The article by Cheung et al,1 “Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL” in this issue of Arteriosclerosis, Thrombosis, and Vascular Biology , demonstrates a possibly important and troubling observation. The addition of an antioxidant “cocktail,” comprising vitamins E and C, β-carotene, and selenium, for participants on simvastatin and niacin (SNA) therapy, resulted in a significant blunting of the apoA1 and HDL2c response compared with those on lipid-lowering drugs alone (SN). None of the HDL-related changes for the antioxidant group only were different from those for placebo.See page 1320 The unexplained results in a clinical trial are often chance findings, given the numerous possible analyses. The statistical test of significance is not meaningful in such an analysis because there was no prior hypothesis before the data were reviewed. …