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No Benefit of Multivitamins for Preventing Cardiovascular Disease in Men

A randomized, controlled trial showed that myocardial infarction, stroke, and death were not affected.

Observational studies of multivitamins for preventing cardiovascular disease (CVD) have yielded inconsistent and mostly negative results, as have randomized controlled trials of individual vitamins and minerals (including β-carotene, selenium, and vitamins B, C, and E). This randomized controlled trial that involved nearly 15,000 male physicians (mean age, 64) who were randomized to commercial daily multivitamins (Centrum Silver) or placebo is a companion analysis to a recently published study that showed a small benefit of multivitamin supplementation for preventing cancer (JW Gen Med Oct 25 2012). Follow-up continued for a median of 11 years.

No difference was found between the groups in risk for any major adverse CVD event, including myocardial infarction, stroke, or cardiac-related mortality. Multivitamin supplementation also was not beneficial in the small subgroup of men with histories of CVD at study entry (5% of participants).

Comment: These findings appear to disprove the suggestion (or hope) that vitamin supplementation prevents CVD, at least in men. The cardiovascular and cancer outcomes from this trial will help clinicians answer patients' questions about the value of multivitamins; additional results from this study (i.e., on preventing eye disease and cognitive decline) are forthcoming.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine November 15, 2012

Citation(s):

Sesso HD et al. Multivitamins in the prevention of cardiovascular disease in men: The Physicians' Health Study II randomized controlled trial. JAMA 2012 Nov 7; 308:1751. (http://dx.doi.org/10.1001/jama.2012.14805)

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Review and add to remarks on this article

• multivitamens & longevity
  Wendell williams, 26 Nov 2012 11:50 AM EST
  Specialty: Unspecified
  We need to know how many milligrams of each vitamin was used.
  
  Too little obviously will not have any significant... [more]
• Results
  Corey L Howard, solo practice, 28 Nov 2012 7:44 AM EST
  Specialty: Internal Medicine
  This study reveals that Centrum Silver does not reduce cardiovascular risk. It indicates nothing regarding other supplementation or specific antioxidants.... [more]
• Centrum Silver? Really?
  Leslie A Batten, Eveningstar Natural Health, 28 Nov 2012 7:44 AM EST
  Specialty: General Preventive Medicine
  This study would have more meaning if a purer form of multi-vitamin were used, and as Mr. Williams pointed out,... [more]
• "We need to know how many milligrams of each vitamin was used."
  Dr Clifford G Andrew, Part Time Assistantt Professor Johns Hopkins, 28 Nov 2012 7:45 AM EST
  Specialty: Neurology
  Centrum Silver Select ingredient from list below for general information, and links to information about its therapeutic use, adverse effects... [more]
• "Too little = no significant effect" and "Effect of large doses"
  Clifford G. Andrew, MD, PhD, Assistant Professor Part Time Johns Hopkins, 28 Nov 2012 7:46 AM EST
  Specialty: Neurology
  As one of the 15,000 physician participants (I took placebo for Vitamin E, C, and Beta-carotene; and the REAL multivitamin... [more]

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