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American Journal of Epidemiology Advance Access originally published online on February 22, 2006
American Journal of Epidemiology 2006 163(8):694-699; doi:10.1093/aje/kwj097
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

Effects of Selenium Supplementation on Cardiovascular Disease Incidence and Mortality: Secondary Analyses in a Randomized Clinical Trial

Saverio Stranges1,*, James R. Marshall2, Maurizio Trevisan1, Raj Natarajan2, Richard P. Donahue1, Gerald F. Combs3, Eduardo Farinaro4, Larry C. Clark {dagger} and Mary E. Reid2

1 Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, NY
2 Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY
3 US Department of Agriculture Human Nutrition Research Center, Grand Forks, ND
4 Department of Preventive Medical Sciences, "Federico II" University of Naples Medical School, Naples, Italy

* Correspondence to Dr. Saverio Stranges, Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, 3435 Main Street, Farber Hall, Room 272, Buffalo, NY 14214 (e-mail: stranges{at}buffalo.edu).

Despite the documented antioxidant and chemopreventive properties of selenium, studies of selenium intake and supplementation and cardiovascular disease have yielded inconsistent findings. The authors examined the effect of selenium supplementation (200 µg daily) on cardiovascular disease incidence and mortality through the entire blinded phase of the Nutritional Prevention of Cancer Trial (1983–1996) among participants who were free of cardiovascular disease at baseline (randomized to selenium: n = 504; randomized to placebo: n = 500). Selenium supplementation was not significantly associated with any of the cardiovascular disease endpoints during 7.6 years of follow-up (all cardiovascular disease: hazard ratio (HR) = 1.03, 95% confidence interval (CI): 0.78, 1.37; myocardial infarction: HR = 0.94, 95% CI: 0.61, 1.44; stroke: HR = 1.02, 95% CI: 0.63, 1.65; all cardiovascular disease mortality: HR = 1.22, 95% CI: 0.76, 1.95). The lack of significant association with cardiovascular disease endpoints was also confirmed when analyses were further stratified by tertiles of baseline plasma selenium concentrations. These findings indicate no overall effect of selenium supplementation on the primary prevention of cardiovascular disease in this population.

antioxidants; cardiovascular diseases; clinical trials; primary prevention; risk; selenium


Abbreviations: CI, confidence interval; HR, hazard ratio; NPC, Nutritional Prevention of Cancer


{dagger} Deceased.


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