VITAMIN E AND STROKES

There are many of my patients who take vitamins and food supplements, thinking that these drugs ( they do not think these are drugs ), enhance their health and give them vitality, and some may even think that these supplements may be anti-aging and also a mild aphrodisiac. There are so many claims. I always put it down to good marketing by these companies, to get their direct selling agents to push their product and yes, many of them push it so well. In fact, almost half of our health expenditure is on health supplements and OTC ( over the counter ) drugs.
Anyway, to day, I would like to comment on a piece of medical research done and published in the Nov 4th issue of the British Medical Journal. This work was led by Dr Markus Schuks from the Bringham and Woman's Hospital, Boston. The researchers studied the effect of Vitamin E on Strokes. The meta-analyse 9 randomised clinical trials ( RCT ) on Vitamin E and strokes. They choosed the 9 RCT which directly compared vitamin E against placebo, in their effects on strokes. All those dealing with multivits or who had other vitamins, were excluded. At one time, there were many such trial because Vit E was thought to have anti-oxidant effects. Anyway, from the 9 RCT, they found a total of 118,765 patients ( this is a very large number of patients ), half on Vit E and half on placebo. At the end of the study, they found that there were equal number of strokes in the Vit E and placebo arm, showing that overall, vitamin E did not reduce the incidence of strokes. They however, further sub- analyse the effects on the two main type of strokes, viz, the hemorrhagic stroke ( stroke due to active bleeding with blood clot in the brain ) and ischemic strokes ( strokes due to loss of blood supply to the brain ). When they did this, they found that vit E did reduce the chance of getting an ischemic stroke by some 10% but it also increase the chance of getting a hemorrhagic stroke by 22%. In other words, the authors worked out that for every 476 person taking Vit E, you prevent 1 ischemic stroke, but for every 1250 person taking Vit E, you may cause 1 hemorrhagic stroke. Overall, Vit E may do more harm then good, as far as stroke is concern.
I suppose all those people who like taking supplements, should be aware, that these supplements, like Vit E, is not as innocent as you think. Stroke is a very serious matter. Do not fool around with it. Once you get it, your whole life changes.
Their meta-analysis also revealed that life-style modification and blood pressure control, remain the most important strategy to prevent strokes, whether it be ischemic or hemorrhagic.