Julissa Jaca Castro

June 27th, 2018

Supplemental Vitamins and Minerals for CVD Prevention and Treatment

Objective: To establish whether individual vitamins or combinations should be taken as supplements for
cardiovascular disease prevention and treatment.

For this they reviewed the evidence of supplemental use a year before and over the last four years since
the guidelines for supplemental use were published by the U.S. Preventive Services Task Force (USPSTF).

Methodology: A systematic review and meta-analysis was conducted of existing systematic reviews and
meta-analyses and single randomized controlled trials (RCTs) published in English from January 2012 (1
year before the USPSTF census) through October 2017 and including the studies reviewed by the USPSTF.
The search strategy used to identify publications (on Cochrane, MEDLINE, and PubMed, and by manual
searches) in that reported randomized control trial (RCT) data on vitamins and minerals with
cardiovascular disease (CVD), CVD components, and all-cause mortality.

Exclusion Criteria: Duplicates, foreign language, less than 6 months, no outcome of interest, no
supplement of interest, no nutrient of interest, no control arm, nonhuman, observational studies, no
supplemental use, and wrong population. Studies that did not meet criteria of inclusion (time period and
were not written in English).

Results:

▪ 179 single RCTs included, of which 15 were new since the USPSTF review.
▪ Of the 4 most commonly used supplements (multivitamins, vitamin D, calcium, and vitamin C),
none had a significant effect on prevention of CVD, MI or stroke.
▪ Folic acid for total cardiovascular disease, folic acid and B-vitamins reducing stroke risk showed
moderate or low-quality evidence for preventive benefits.
▪ The following showed a lack of harm or benefit or null effect: multivitamins, vitamins C, D, β-
carotene, calcium, and selenium.
▪ Antioxidant mixtures and niacin with a statin had no effect on CVD outcomes but resulted in
increased risk for all-cause mortality.

Conclusions:

▪ Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including
deficiency and sufficiency) was not demonstrated.
▪ Vitamin or mineral supplement use does not prevent or treat cardiovascular disease (CVD),
except for folic acid, which reduced stroke an CVD risk.
▪ Rather than supplemental use adopting healthy dietary patterns and plant-based diets, that
contain and meet required vitamins and minerals, are recommended.

Referenced Article: Jenkins, D. J., Spence, J. D., Giovannucci, E. L., Kim, Y. I., Josse, R., Vieth, R., &
Paquette, M. (2018). Supplemental vitamins and minerals for CVD prevention and treatment. Journal of
the American College of Cardiology, 71(22), 2570-2584.