High Vitamin E Levels Linked to Increased Cardiovascular Risk: Study Reveals J-Shaped Association
China: A large cross-sectional study published in BMC Cardiovascular Disorders has found a complex, J-shaped relationship between serum vitamin E levels and the risk of cardiovascular diseases (CVDs). Led by Jian Li from the Department of Neurology at Beijing Chao Yang Hospital, Capital University of Medical Sciences, Beijing, China, the study highlights the importance of maintaining vitamin E within an optimal range to minimize cardiovascular risk.
CVDs remain a leading cause of mortality worldwide, and identifying modifiable risk factors is essential for prevention strategies. This study aimed to evaluate whether vitamin E, a commonly consumed antioxidant, plays a protective or harmful role in cardiovascular health.
The researchers analyzed data from 3,516 adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002. Serum vitamin E levels were determined using high-performance liquid chromatography, and participants’ cardiovascular status was assessed through structured interviews and questionnaires. The team employed multivariable logistic regression and segmented linear modeling to assess associations between vitamin E levels and CVD risk.
The study revealed the following findings:
- The analysis identified a J-shaped relationship between serum vitamin E levels and cardiovascular disease (CVD) risk.
- Both low and high vitamin E concentrations were found to be potentially harmful.
- Individuals with vitamin E levels below 85.24 µg/dL showed a slight trend toward reduced CVD risk, but this was not statistically significant.
- CVD risk began to rise significantly when vitamin E levels exceeded 85.24 µg/dL.
- Those with very high vitamin E levels had a 4.18-fold increased risk of developing CVD compared to individuals with mid-range levels (OR: 4.18).
This finding points to a potential tipping point: while vitamin E is often perceived as beneficial due to its antioxidant properties, excessive levels may, in fact, contribute to cardiovascular harm. The researchers suggest that imbalances—whether deficiency or over-supplementation—can disrupt cardiovascular health, emphasizing the need for careful monitoring and guidance around vitamin E intake.
Importantly, the authors caution that because the study is cross-sectional in design, it cannot establish a direct cause-and-effect relationship. Unmeasured confounding factors may also influence the observed associations. Nonetheless, the findings raise important considerations for clinical practice and public health, particularly in the context of supplement use.
The authors concluded, "The study provides valuable evidence that more is not always better when it comes to micronutrients like vitamin E. Maintaining serum levels within an appropriate range appears critical for cardiovascular health, and future longitudinal and interventional research is needed to validate these observations and refine recommendations."
Reference:
Li, J., Li, C., Tao, L. et al. Serum vitamin E and cardiovascular diseases risk: a J-shaped association in a large cross-sectional study. BMC Cardiovasc Disord 25, 489 (2025). https://doi.org/10.1186/s12872-025-04779-5
