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Women and heart disease.

For those in search of the solution to the French paradox, Dr Michel de Lorgeril has a suggestion: “Cherchez les femmes.”

The differences in the rates of heart disease between the residents of nations where the Mediterranean diet is followed and the rest of Europe and the United States are well known, said Dr de Lorgeril, a researcher at Explorations Fonctionnelles Cardiorespiratoires et Metaboliques at the University of St. Etienne in France. However, the French are much more likely to eat like their northern European neighbors and yet experience heart disease rates more like people who live in nations to the south. For example, he said, mortality from coronary heart disease in British men aged 55 to 64 years was 487 per 100 000 in 1992; it was only 128 in French men. For women, the corresponding numbers were 128 in Britain and 27 in France. However, the 2 national groups reported similar risk factors, including an almost equal consumption of fat (Law M, Wald N. Why heart disease mortality is low in France: the time lag explanation. BMJ. 1999;318:1471–1476).

The bottom line of the Cambridge Heart Antioxidant (CHAOS) trial, which sought to determine the effect of vitamin E on the risk of myocardial infarction and cardiovascular disease–related death, is …