Vitamin E is a fat-soluble antioxidant, and its use in arteriosclerosis (hardening and narrowing of the arteries) has a scientific basis rooted in its ability to inhibit oxidative modification of low-density lipoproteins (LDL), a process implicated in the development of atherosclerosis. Beta-tocopherol is one of several naturally occurring tocopherols, with alpha-tocopherol being the most studied form. Several epidemiological studies and early clinical trials have suggested that higher intake of vitamin E is associated with a lower risk of cardiovascular disease, likely due to its antioxidant properties.

However, large-scale randomized controlled trials (RCTs), such as the HOPE and the Heart Protection Study, have not demonstrated a significant benefit of vitamin E supplementation (including various tocopherol forms) in preventing cardiovascular events or progression of arteriosclerosis in the general population. Some studies have even suggested potential harm or no effect. The American Heart Association and other major organizations do not recommend vitamin E supplementation for the prevention or treatment of arteriosclerosis due to the lack of consistent, high-quality evidence supporting efficacy.

In summary, while there is a solid scientific rationale and some supportive observational data, robust clinical evidence for the use of vitamin E (including beta-tocopherol) in the treatment or prevention of arteriosclerosis is limited and inconsistent. The overall rating of evidence is therefore low (2 out of 5).