Veggie Blog

The old version of this post said that vitamin E opens up arteries and prevents heart attacks, that vitamins C and E together protect the heart, and that people should take 400 international units of vitamin E and 500 mg of vitamin C twice a day. Those claims reflect a theory that was popular decades ago. Large trials later tested it, and the results were disappointing. Here is what the research found.

Why did people think vitamin E would protect the heart?

The idea was reasonable. Oxidized cholesterol sticks to the walls of arteries, and antioxidants such as vitamins E and C can limit damage from free radicals. The old post described this process correctly. According to the NIH Office of Dietary Supplements (ODS), researchers have examined whether vitamin C might help prevent or delay diseases in which oxidative stress plays a role, including cardiovascular disease. Theory is not the same as proof, though, and heart disease is one of the areas where it was tested thoroughly.

What did the large trials find?

For vitamin E, the answer is clear. ODS reports that the HOPE study followed almost 10,000 patients at high risk of heart attack or stroke for 4.5 years, and found that those taking 400 IU of natural vitamin E a day had no fewer cardiovascular events than those taking a placebo. In the follow-up study HOPE-TOO, almost 4,000 of the participants took it for 2.5 more years. After seven years, vitamin E provided no significant protection against heart attacks, strokes or deaths, and the people taking it were 13 percent more likely to have heart failure and 21 percent more likely to be hospitalized for it, an unexpected finding. ODS concludes that moderately high doses of vitamin E do not reduce the risk of serious cardiovascular events in people over 50 with established heart disease or diabetes. That is the opposite of what the old post said about people who have had a heart attack.

And vitamin C?

ODS says that most clinical trials have not found conclusive evidence that vitamin C supplements can protect against cardiovascular disease. It adds that high intakes of fruit and vegetables are associated with a reduced risk of heart disease, which may be partly due to their antioxidant content, but that does not show that pills do the same. The old post suggested 500 mg twice a day. The tolerable upper intake level for adults is 2,000 mg a day, and ODS says that vitamin C has low toxicity, but more than you need will not protect your heart. Our post on vitamin C: why you need it and where to find it explains what it is for.

What do the experts recommend?

The U.S. Preventive Services Task Force (USPSTF) issued a 2022 recommendation on this question. It recommends against using beta-carotene or vitamin E supplements to prevent cardiovascular disease or cancer in community-dwelling adults who are not pregnant. For multivitamins and for other single or paired supplements, it concludes that the evidence is insufficient to recommend for or against. In plain terms, no vitamin pill has been proven to protect the heart, and two common ones are advised against. You can read the statement here: USPSTF recommendation on vitamin supplements.

So what does help your heart?

Food and habits do. The old post was right that nuts contain vitamin E and are good for you. ODS notes that foods rich in vitamin E include nuts and seeds, and a diet with plenty of fruit, vegetables, whole grains and fish supports heart health in ways a single vitamin cannot. The National Heart, Lung, and Blood Institute’s heart-healthy living advice covers choosing heart-healthy foods, aiming for a healthy weight, getting regular physical activity, managing stress, quitting smoking and getting enough good-quality sleep; see the NHLBI guide to heart-healthy living. Our post on what you can do to lower your cholesterol gives practical steps, and cholesterol, vitamins and drugs explains where statins fit in.

Should you take a supplement anyway?

If your doctor has diagnosed a deficiency, follow the advice. If you have heart disease and take medicine, check with your doctor before adding any supplement, because some can interact with heart medicines. Do not rely on vitamins instead of prescribed treatment. See vitamins and your health for how to choose and use supplements wisely.