10 Nov Multivitamins May Have Little Influence on Cardiovascular Disease

MedicalResearch.com Interview with:
Susanne Rautiainen, PhD
From the Department of Institute of Environmental Medicine
Karolinska Institutet, Stockholm, Sweden
Divisions of Preventive Medicine  Department of Medicine,
Brigham and Women’s Hospital and Harvard Medical School, Boston, MA

Medical Research: What is the background for this study? What are the main findings?

Dr. Rautiainen: Multivitamins are the most commonly used dietary supplement in the US and other developed countries and it has been shown that many take them with the goal of maintaining or improving their health. Multivitamins typically provide low-doses of essential vitamins and minerals to prevent deficiency. Yet many people who take multivitamins are not deficient. Despite the widespread use, limited number of studies have investigated how multivitamins are associated with major chronic diseases, including cardiovascular disease. We therefore examined how self-reported multivitamin use was associated with both short- and long-term risk of cardiovascular diseases in the Women’s Health Study which is a prospective cohort of 37,193 women aged ≥45 years and free of CVD and cancer at baseline.

In this study of middle-aged and elderly women who were apparently healthy at baseline and followed for an average of 16.2 years, we observed that multivitamin use was not associated with neither short- nor long-term risk risk of major CVD events, including MI, stroke, or CVD death. Moreover, there was no significant association observed for women who had taken multivitamins for ≥10 years at baseline. There were some important indications that the association between multivitamin use and long-term risk of major CVD events may be modified by age and fruit and vegetable intake, suggesting that women who were older and had low fruit and vegetable intake may benefit more from multivitamin supplement use. However, these results should be interpreted with caution. Moreover, relying on self-reports of multivitamin use may be subject to misclassification, plus other unmeasured factors may have biased the results despite our best effort to account for everything.

Medical Research: What should clinicians and patients take away from your report?

Dr. Rautiainen: Taken together, today there is limited evidence to recommend for or against the use of multivitamins in the prevention of cardiovascular disease. A healthy diet characterized by high amounts of fruits and vegetables, whole grains, and fish should be recommended to avoid nutritional deficiencies and in the prevention of chronic diseases such as cardiovascular disease. Whether multivitamins may be beneficial in preventing cardiovascular disease in particular subgroups of individuals remains unknown and in need of further studies such as large-scale randomized clinical trials. Previous results from clinical trials looking at the effect from single high-dose vitamin supplements should not be generalized to multivitamin supplements since they include a mixture of broad spectrum of low-doses of vitamin and minerals.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Rautiainen: There is still a great need for studies to understand whether multivitamin supplements can prevent different cardiovascular diseases or its major risk factors, including hypertension, hypercholesterolemia, and diabetes. Future studies should investigate the importance of nutritional status and whether particular subgroups of individuals should be targeted to take multivitamin supplements – or not.

Citation:

Multivitamin use and cardiovascular disease in a prospective study of women
Susanne Rautiainen, I-Min Lee, Pamela M Rist, J Michael Gaziano, JoAnn E Manson, Julie E Buring, and Howard D Sesso
Am J Clin Nutr 2015 ajcn.088310; First published online November 5, 2014. doi:10.3945/ajcn.114.088310

Last Updated on November 10, 2014 by Marie Benz MD FAAD