A time to stop prescribing antioxidant vitamins to prevent and treat heart disease?

The article by Cheung et al, 1 “Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL” in this issue of Arteriosclerosis, Thrombosis, and Vascular Biology, demonstrates a possibly important and troubling observation. The addition of an antioxidant “cocktail,” comprising vitamins E and C, b-carotene, and selenium, for participants on simvastatin and niacin (SNA) therapy, resulted in a significant blunting of the apoA1 and HDL2c response compared with those on lipid-lowering drugs alone (SN). None of the HDL-related changes for the antioxidant group only were different from those for placebo.