VITAMIN E. A British study concluded that a dime's worth of vitamin E seemed to reduce heart attacks by 75 percent when taken daily by people with bad hearts.
The finding stunned researchers, who wondered why, if so many people take vitamins, such a discovery hadn't been made before.
``I'm puzzled. Most of my colleagues are puzzled,'' said Thomas Ryan, a physician at Boston University.
Doctors have noticed in recent years that people who consume lots of vitamin E supplements seem to lower their risk of heart attacks. But until now, no one had conducted a large experiment to see if vitamin E pills actually do this.
Researchers led by physician Nigel G. Brown of Northwick Park Hospital in suburban London enrolled 2,002 people with serious heart disease and randomly assigned them to take either dummy pills or pills containing either 400 or 800 international units of vitamin E a day. (The U.S. recommended daily allowance is just 15 units for men and 12 for women.)
After 17 months of follow-up, 50 people had died of heart disease and 55 had suffered nonfatal heart attacks. Fourteen of the nonfatal heart attacks were among the vitamin takers, 41 in the placebo group.
That didn't translate into longer life, however. Deaths from all kinds of heart disease were evenly split between the two groups. The researchers say there are possible explanations for this, including the high rate of congestive heart failure, which vitamin E doesn't help.
Vitamin E is one of a group of nutrients known as antioxidants. It is thought to thwart the process that leads to the build up of fatty deposits in the arteries.
The researchers saw no unwanted side effects from the vitamin, so some doctors said they see no reason to avoid it.
AFRICAN AMERICANS. Researchers have long noticed that when heart disease strikes, its impact is harder on blacks.
Sorting out why is difficult, but the latest research provides some clues.
Researchers at Duke University followed up on 12,402 patients - 10 percent of them black - who had blockages in their heart arteries. Such blockages are the major underlying cause of heart disease.
Five years later, 27 percent of the blacks had died, compared with 20 percent of the whites - a 35 percent difference in mortality.
Socioeconomic differences ``can explain only a minor part of the difference,'' said Dr. Eric Peterson.
His study found that insurance was probably not an important factor, since everyone was already in the care of a cardiologist and had received an angiogram to visualize the arteries.
The mortality difference also could not be blamed on differences in severity of disease between blacks and whites. Blacks got to the doctor sooner after the start of chest pain and turned out to have less extensive blockages in their arteries.
However, black people were 1 1/2 to two times more likely than whites to have high blood pressure or diabetes, both of which make heart trouble tougher to treat.
The researchers concluded that these complicating diseases could explain about one-half to two-thirds of the increased mortality among the black patients.
They also saw that blacks were 40 percent less likely than whites to get bypass surgery or angioplasty. This difference could explain perhaps 25 percent of the increased risk of death, the researchers said.
The study could not sort out why blacks were less likely to get these expensive procedures, but insurance is not the sole reason.
``Some feel that culturally blacks are less likely to accept such an invasive procedure as bypass surgery or angioplasty,'' said Charles Curry of Howard University. ``Others feel that maybe the doctors are not good at communicating to many black patients the need for surgery. . . .
