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Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment: JACC Focus Seminar

David J A Jenkins1, J David Spence2, Edward L Giovannucci3

  • 1Department of Nutritional Sciences, Temerty, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Clinical Nutrition Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada.

Journal of the American College of Cardiology
|January 29, 2021
PubMed

Insights

Vitamin and mineral supplements show limited benefits for cardiovascular health. Folic acid and B vitamins may prevent stroke, but multivitamins, vitamin D, calcium, and vitamin C show no effect. Niacin with statin increased mortality risk.

Area of Science:

  • Nutrition Science
  • Cardiovascular Health
  • Evidence-Based Medicine

Background:

  • Systematic reviews and meta-analyses are crucial for evaluating vitamin and mineral supplementation effects.
  • Previous research in 2018 highlighted specific benefits and risks of supplementation.
  • Understanding the impact of supplements on cardiovascular disease (CVD) outcomes and mortality remains a public health priority.

Purpose of the Study:

  • To provide an updated systematic review and meta-analysis of vitamin and mineral supplementation on cardiovascular disease outcomes and all-cause mortality.
  • To synthesize evidence from new randomized controlled trials (RCTs) and meta-analyses published since the last review.
  • To assess the quality of evidence using the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach.

Main Methods:

  • Conducted comprehensive literature searches in Cochrane Library, Medline, and Embase.
  • Analyzed data using random effects models to account for heterogeneity.
  • Classified evidence quality according to the GRADE approach to assess certainty of findings.

Main Results:

  • Folic acid and B vitamins demonstrated preventive benefits for stroke, with moderate quality evidence.
  • Commonly used supplements including multivitamins, vitamin D, calcium, and vitamin C showed no significant effect on CVD outcomes or mortality.
  • Niacin, when used in conjunction with statins, was associated with an increased risk of all-cause mortality.

Conclusions:

  • Supplementation with folic acid and B vitamins may offer a moderate-quality benefit for stroke prevention.
  • There is a lack of conclusive evidence for the benefits of most vitamin and mineral supplements, especially when dietary intake is sufficient.
  • Niacin in combination with statins requires caution due to an increased risk of all-cause mortality.

Keywords:
all-cause mortalitycardiovascular diseasemeta-analysissupplements

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