Prophylactic Antioxidant Intake by Cardiologists
April 1998; Volume 1: 47-48
Source: Mehta J. Intake of antioxidants among American cardiologists. Am J Cardiol 1997;79:1558-1560.
Many studies have been con-ducted to examine the potential of antioxidants in preventing coronary artery disease (CAD) events and cancers. Mehta surveyed cardiologists listed in the American College of Cardiology directory; the survey was returned by 181 of 450 to whom it was faxed. The mean age of respondents was 46 ( range, 24-81 years).
The author found that almost half (44%) of all respondents took prophylactic antioxidants themselves. In general, vitamin E was the most commonly used antioxidant vitamin (39%), followed by vitamin C (33%) and beta carotene (19%). The most common dose of aspirin taken was 325 mg daily; of vitamin E, 400 IU daily; vitamin C, 500 mg daily; and beta carotene, 20,000 units daily. Mehta also observed that a similar percentage took routine aspirin (42%) as took antioxidants; 28% took both. Thirty-seven percent of cardiologists self-reported routinely prescribing antioxidants to their patients with CAD.
COMMENT
There is selection bias in this report's methods, as the respondents' self-reported prevalence of hypertension, diabetes, and smoking, among other risk factors, was much lower than in the Physicians' Health Study or in the Framingham study. In addition, the numbers are small and the follow-up apparently absent. Despite these problems, this study of physicians suggests that physicians may practice primary and, presumably, secondary prevention a bit more than they preach it.
More recent reports argue meaningfully for dosages of vitamin E up to 800 IU daily and vitamin C up to 1000 mg daily to block endothelial oxidative stress.1
Recommendation
This creative effort deserves a follow -up study. Although the best way to take vitamins is by eating food, this is inadvisable for foods with lots of vitamin E, and supplements are indicated to reduce coronary disease risk. Because physicians who model lifestyle management behavior are more likely to be persuasive with their patients than those who do not, all clinicians should personally consider dietary supplementation with vitamin E and perhaps with vitamin C as well.
Reference
1. Plotnick GD, Corretti MC, Vogel RD. Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery activity following a single high-fat meal. JAMA 1997; 278:1682-1686.
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