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Randomised vitamin E supplementation and risk of chronic lung disease in the Women's Health Study
  1. Anne H Agler1,
  2. Tobias Kurth2,3,4,
  3. J Michael Gaziano2,5,6,
  4. Julie E Buring2,
  5. Patricia A Cassano1
  1. 1Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
  2. 2Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  3. 3INSERM Unit 708–Neuroepidemiology, Paris, France
  4. 4University Pierre et Marie Curie, Paris, France
  5. 5Division of Aging, Brigham and Women's Hospital, Boston, Massachusetts, USA
  6. 6Massachusetts Veteran's Epidemiology, Research and Information Center (MAVERIC), Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA
  1. Correspondence to Dr P A Cassano, 209 Savage Hall, Cornell University, Ithaca, NY 14853, USA; pac6{at}


Background The oxidant/antioxidant balance in lung tissue is hypothesised to contribute to the risk of chronic obstructive pulmonary disease (COPD). Observational studies consistently report higher antioxidant status associated with lower COPD risk, but few randomised studies have been reported.

Methods A post hoc analysis of 38 597 women without chronic lung disease at baseline was conducted in the Women's Health Study (WHS) to test the effect of vitamin E on the risk of incident chronic lung disease. The WHS is a randomised double-blind placebo-controlled factorial trial of vitamin E (600 IU every other day) and aspirin (100 mg every other day) in female health professionals aged ≥45 years. Using Cox proportional hazards models, the effect of randomised vitamin E assignment on self-reported physician-diagnosed chronic lung disease was evaluated.

Results During 10 years of follow-up (376 710 person-years), 760 first occurrences of chronic lung disease were reported in the vitamin E arm compared with 846 in the placebo arm (HR 0.90; 95% CI 0.81 to 0.99; p=0.029). This 10% reduction in the risk of incident chronic lung disease was not modified by cigarette smoking, age, randomised aspirin assignment, multivitamin use or dietary vitamin E intake (minimum p for interaction=0.19). Current cigarette smoking was a strong predictor of chronic lung disease risk (HR 4.17; 95% CI 3.70 to 4.70; vs. never smokers).

Conclusions In this large randomised trial, assignment to 600 IU vitamin E led to a 10% reduction in the risk of chronic lung disease in women.

  • Pulmonary disease
  • chronic obstructive
  • antioxidants
  • tocopherols
  • intervention studies
  • randomised controlled trial
  • COPD epidemiology

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  • Funding This study was funded by grants from the National Institutes for Health, USA, grants NIH HL071022 (PAC); NIH HL043851 and CA47988 (Women's Health Study).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Brigham and Women's Hospital and Cornell University (for analyses in this study of previously collected data). The Women's Health Study was approved by the institutional review board of Brigham and Women's Hospital and monitored by an external data and safety monitoring board.

  • Provenance and peer review Not commissioned; externally peer reviewed.