PHS II: Multivitamin Use Does Not Reduce CVD Risk in Men

Daily, long-term multivitamin use does not reduce the risk of cardiovascular disease (CVD) or death, according to results from the Physicians Health Study (PHS) II released on Nov. 5 as part of AHA 2012 and simultaneously published in the Journal of the American Medical Association.

Between 1997 and 2011, the study randomized 14,641 male U.S. physicians initially aged 50 years or older (mean 64.3 years) to a commonly used daily multivitamin, Centrum Silver (Pfizer) or placebo. Participants were followed for the incidence of the composite endpoint of major cardiovascular events, including nonfatal myocardial infarction (MI), nonfatal stroke and cardiovascular death. Secondary outcomes included the incidence of MI and stroke.

Over the course of a median 11.2 years of follow-up, 1,732 participants had a major cardiovascular event: 652 cases of a first MI, 643 cases of a first stroke and 829 cardiovascular deaths. There was no difference in the event rates between multivitamin and placebo (11 events per 1,000 person-years versus 10.8 events per 1,000 person-years, respectively; p=0.91). Multivitamin use also did not reduce the risk of total MI, total ischemic or hemorrhagic stroke, cardiovascular death or other cardiovascular issues, including congestive heart failure, angina or the need for coronary revascularization. In secondary analyses, there was a slight reduction in fatal MI, but this was likely attributable to chance, according to the investigators.

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In an accompanying editorial, Eva M. Lonn, MD, MSc, Medicine and Popular Health Research Institute, McMaster University, Hamilton, Ontario, commented that despite an absence of solid evidence supporting the benefits of multivitamins, their use is ubiquitous, with 39 percent of the U.S. population using "vitamins and other dietary supplements as a simple and miraculous escape from the difficult and complex task of implementing effective prevention strategies."

"Many people with heart disease and risk factors, or previous CVD events, lead sedentary lifestyles, eat processed or fast foods, continue to smoke and stop taking lifesaving prescribed medications, but purchase and regularly use vitamins," she said. "This distraction from effective CVD prevention is the main hazard of using vitamins and other unproven supplements."

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