Vitamin E, encompassing both tocopherols and tocotrienols, has been investigated for its potential role in supporting cardiovascular health due to its antioxidant properties, which may help protect lipids from oxidative damage—a process implicated in atherosclerosis. Early observational studies suggested that higher vitamin E intake or supplementation was associated with reduced risk of coronary heart disease. This led to widespread interest and use of vitamin E for cardiovascular disease (CVD) prevention.

However, large randomized controlled trials (RCTs), including the Heart Outcomes Prevention Evaluation (HOPE) study and the Women's Health Study, have failed to demonstrate significant cardiovascular benefit from vitamin E supplementation in the general population. Some meta-analyses have even suggested a possible increase in all-cause mortality at high doses. Research on tocotrienols, a lesser-studied form of vitamin E, is more limited but shows some promise in improving lipid profiles and reducing inflammation in preclinical and small clinical studies; however, robust evidence from large clinical trials is lacking.

Overall, while there is a scientific rationale and some early supportive data, high-quality evidence from large trials does not support the use of vitamin E (mixed tocopherols and tocotrienols) for the prevention or treatment of cardiovascular disease. Current guidelines do not recommend routine vitamin E supplementation for CVD prevention.